Temp Remote Pharmacy Billing & Compliance Analyst - Phaxis LLC
Remote, NY 10065
About the Job
TEMP REMOTE PHARMACY BILLING & COMPLIANCE ANALYST AT NYC HEALTHCARE FIRM
Hourly Pay Rate $33.65 to $37.54 (based upon candidate and experience)
Incredible Organization with Equally Incredible People | Temporary Assignment ONLY
Top NYC Healthcare Firm is looking for a dedicated, detail-oriented, analytical professional to join its Pharmacy Administration Team for a Three to Five (3-5) Month Temporary Assignment as a Remote Pharmacy Billing & Compliance Analyst . In this role, you will provide an array of analytical and compliance duties/tasks to support the Pharmacy Administration Team .
Fully Remote from Anywhere in USA but MUST work East Coast Hours. Full-time (37.5-hrs Weekly); Mon-Fri (7.5-hrs Daily); 8am-4pm (Eastern). Incredible organization where you feel as though you are "giving back”.
REQUIREMENTS AND SKILLS
DUTIES AND RESPONSIBILITIES
Pharmacy Billing Compliance (40% of the Time)
Billing compliance for various types of medications and associated charges.
Performance Expectations:
Performance Expectations:
Performance Expectations:
Completes projects and/or activities, which meet departmental criteria to maintain and advance professional competency based on divisional guidelines.
Performance Expectations:
JD # 24-05017
Hourly Pay Rate $33.65 to $37.54 (based upon candidate and experience)
Incredible Organization with Equally Incredible People | Temporary Assignment ONLY
Top NYC Healthcare Firm is looking for a dedicated, detail-oriented, analytical professional to join its Pharmacy Administration Team for a Three to Five (3-5) Month Temporary Assignment as a Remote Pharmacy Billing & Compliance Analyst . In this role, you will provide an array of analytical and compliance duties/tasks to support the Pharmacy Administration Team .
Fully Remote from Anywhere in USA but MUST work East Coast Hours. Full-time (37.5-hrs Weekly); Mon-Fri (7.5-hrs Daily); 8am-4pm (Eastern). Incredible organization where you feel as though you are "giving back”.
REQUIREMENTS AND SKILLS
- High School Diploma or GED required; College Degree preferred, but not required.
- Drug Coding required .
- Data Analytics required .
- Knowledge of EPIC Willow Charge Capture process within the EPIC (EHR-Electronic Health Record) Software System required.
- Quick Learner with Proven Digital Aptitude.
DUTIES AND RESPONSIBILITIES
Pharmacy Billing Compliance (40% of the Time)
Billing compliance for various types of medications and associated charges.
Performance Expectations:
- Review organization's compliance/risk management tool daily: analyze and report any pharmacy related coding changes; and recommend appropriate policy and procedure changes to the management team.
- In collaboration with Patient Accounts, audit pharmacy charge records and make charge/credit adjustments where necessary.
- Represent the Pharmacy Division in internal and external audits related to pharmacy billing; implements policy and procedure changes that result.
- Perform routine audits and quality assurance reviews of pharmaceutical charge activities.
- Identify potential areas of compliance vulnerability and risk; Develop and make recommendations for corrective action.
- Provide general guidance and advice to pharmacy leadership on compliance issues and resolution.
- Audit retail medication reversals and re bills for compliance accuracy.
- Responsible for the maintenance and update of all Pharmacy policies and procedures related to pharmacy billing compliance.
Performance Expectations:
- Responsible for ensuring timely and accurate billing via the automated interface between our clinical pharmacy and patient accounts/finance systems.
- Review billing exception reports and reasonability bases lines to ensure appropriate billing.
- Provide direct support to Pharmacy, Patient Accounts or other organization staff for pharmacy billing inquiries and trouble calls.
- Manage a bi-annual update of pharmaceutical AWP prices, ensuring coordination between the Pharmacy clinical system and our patient accounts and finance systems.
- Conduct a quarterly analysis of our pharmaceutical prices by comparing average acquisition costs to average wholesale prices; determine if any price adjustments are appropriate; and implement adjustments at the direction of Pharmacy management.
- Review discrepancies between the date of administration and the date of the pharmacy charge; perform chart reviews to determine the appropriate date of service; make charge corrections where necessary; and recommend order corrections to pharmacy staff.
- Review pharmacy charge related IDB quality reports, perform chart reviews to determine if corrective action is required.
- Manage pharmacy medication pump billing and tracking program.
- Implement a pharmacy division billing compliance education and training program.
- Respond to Patient Account inquiries regarding retail prescriptions; evaluate, identify, and address billing discrepancies; escalate as needed to pharmacy leadership.
- Execute a monthly reconciliation of expected and actual retail prescription reimbursements from prescription plan payers to ensure that MSK is receiving all due payments.
- SQL Report Writing skills.
Performance Expectations:
- Assist pharmacy informatics staff in all aspects of routine internal and external compliance audits.
- Issue charges or credits as directed by the manager of Pharmacy Billing to address inappropriate medication charges.
- Participate in system testing projects, especially those related to medication billing compliance.
- Identify gaps in existing reports and designs new ones using report writing tools and software, such as SQL.
- Perform any other project at the direction of the manager of Pharmacy Billing.
Completes projects and/or activities, which meet departmental criteria to maintain and advance professional competency based on divisional guidelines.
Performance Expectations:
- Attend/document attendance of Pharmacy sponsored meetings, i.e. continuing education programs, grand rounds, and general staff meetings when coverage is available, and workload permits.
- Participate in any relevant/related training sessions at the direction of the Manager of Pharmacy Billing (5 hours of attendance or greater = Meets Expectation)
JD # 24-05017
Source : Phaxis LLC