Pharmacy Audit/Reimbursement Specialist-Lifespan Pharmacy

LifeSpan Pharmacy, a CarDon & Associates partner, is now seeking a Pharmacy Audit/Reimbursement Specialist. Weekly pay and great benefits!

BASIC FUNCTION: * Primary responsibility is to work and respond to audit requests from various third parties

• Secondary responsibility will be to keep up with audit/reimbursements trends to help with purchasing and formulary decisions.

• This may include tasks in 3rd party reconciliation and deposits

EDUCATION, QUALIFICATIONS, CREDENTIALS: * Indiana pharmacy technician license preferred but not required

• Understanding of Medicare/Medicaid/Insurance pay types, billing codes, and brand/generic medications required

• Working knowledge of Microsoft Excel and long-term care pharmacy applications such as FrameworkLTC, FrameworkECM, and Sage300 accounting software strongly preferred.

• Multi-tasking and experience in leading a team is preferred.

RESPONSIBLE TO: Billing Manager/Informatics Pharmacist

ESSENTIAL FUNCTIONS: The Pharmacy Audit/Reimbursement Specialist must be able to perform each essential function effectively to be successful in this position. This is a hybrid remote position that may require months in the office before remote work, and then 1-2 office days/week thereafter

• Audit Requests (40%)

• Respond to audit requests in a timely manner with frequent updates to management.

• Identify trends and provide feedback to team leads to ensure compliance from all departments. Reconciliation and Cash Posting (20%)

• Reconciliation and Cash Posting o Reconciliation of 3rd Party Remits o Posting of Private Pay Payments

• Maintaining & Balancing Daily Cash Flow Spreadsheet Collections and Customer Relations (10%) Maintains assigned facilities accounts receivable aging, investigating and resolving non-payment issues

• Private Pay accounts receivable aging, collections

• Third Party accounts receivable aging, collections, contract compliance Pre-billing and Billing (10%)

• Reviews private pay statements for assigned facilities, giving past dues to collections, credit balances to supervisor or manager for investigation, and mailing out the remainder in a timely manner

• Resolves questions and/or concerns from facilities regarding monthly statements, making corrections or adjustments as needed

• Prepare price quotes as requested Special Pricing of Resident Accounts (10%)

• Set up residents accounts appropriately

• Monitor and review each account prior to month end review

• Correspond special pricing changes to residents as required General Office (10%) Filing

• Attends training as provided in order to improve self and quality of work

• Audits -- Pulling necessary paperwork

• Accepts other duties as assigned The preceding list of essential functions is not exhaustive and may be supplemented.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Advanced computer skills, including moderate excel & adobe functions

• Ability to exhibit effective verbal and written communication skills

• Ability to understand and exhibit a willingness to perform new job processes

• Attributes and Attitude Characteristics

• Maintains high level of attendance and punctuality

• Communicates in a positive and respectful manner with customers and internal team members

• Exhibits a "team work" attitude o Supports LifeSpan's mission and high standard of customer service