Rx Revenue Cycle Coordinator

Doctor's Hospital At Renaissance Edinburg , TX 78540

Posted 1 week ago

POSITION SUMMARY:This position ensures quality services by acting as a liaison between pharmacy department, billing, revenue cycle, accounting and leadership. This coordinator will review hospital-wide inventory, purchases, charges and charge codes as well as pharmacy financials and monthly inventory data pharmaceutical medications purchased.

The coordinator serves as a resource for pharmacy director, revenue cycle director, accounting, CFO and leadership for any issues arising with medication accountability, billing and proper coding and wastage of medications.POSITION RESPONSIBILITES:* Responsible for building and maintain medication formulary (Inpatient, Outpatient, Clinics, etc.) , all activities dealing with new medications purchased, ensuring proper documentation of medication wastage, inventory, correct billing in terms of federal and state requirements and final bill reconciliation of charges in all current systems (Paragon, Cerner, Prcing Tool, etc.. ) that is being utilized by facility.* Assists with general revenue cycle duties as appropriate.* Assists with general pharmacy duties as appropriate.* Participates in the quality assurance and performance improvement activities of the program. Personnel* Performs ongoing training of medication interfaces dealing with medications, ndc, charges codes, J codes ,final billing, etc.. Actively seeks ways to improve level of performance in dealing with pharmacy cost, revenue, audits, wastage and hospital formulary. Team Meetings* Responsible for daily huddles as needed, monthly meeting with all team members, and monthly meeting with department* Responsible for providing weekly follow up and feedback on required actions based on meeting discoveries, hospital accounting audits.

Supervision* Schedules regular in-service programs to keep team members current in medication formulary, billing, wastage issues, etc..* Responsible for staying current with state and federal regulations which govern medications. Financial Management* Works closely with revenue liaison team member, billing, and revenue cycle for billing compliance, timely closing and hospital charges* Operates within the context of an established budget* Assures that drug formulary, billing, charges and wastage documentations are properly being managed monthly. Keeps director informed of department activities on a weekly basis in regard to:

Avoidable medication billing issues Fiscal and/or inventory issues Any other statistics as may be required Responsible for overseeing the inventory levels on a quarterly basis* Reviews on a daily basis missed charges and/or patient information properly flowing through pharmacy interfaces.* Establishes and implements financial controls* Responsible for review of daily interface billing issues for accuracies/completeness* Responsible for pharmacy charges posed daily and reviews for inaccuracies/completeness* Responsible for reviewing monthly pharmacy financials and identifying areas of improvement* Responsible for delivering pharmacy operation monthly report as assigned Pharmacy Operations* Oversees daily pharmacy billing operations* Assists team members in understanding/implementing of pharmacy formulary and charging procedures* Maintains requirements of accreditation and regulatory agencies, i.e. Joint Commission, Texas State Board of Pharmacy, CMS, DEA.* Handles complaints from clinics, patients or physicians with excellent customer service skills and monitors patient service feedback and helps resolves complaints and service issues* Is required to acquire all pertinent information on patient complaints and start the first step to service recovery with emphasis on the importance of improving the patient experience Pharmacy and Medical Record Activity* Responsible for maintaining a current, accurate medical record* Responsible for assuring accurate and timely entries of pertinent information on: Invoices Reports from outside facilities Needy Meds Responsible for assuring quality, confidentiality and timeliness of activities, whether, preformed in-house or by an outside vendors* Responsible for maintaining a policy to assure confidentiality of Medical Records Department Maintenance* Ensures department is properly maintained and functional by communicating with Revenue Cycle Accounting Pharmacy Department/Supervisors CFO/Leadership Time Management* When necessary acts as a liaison between the pharmacy department, all revenue/billing staff or other departments Practice Enhancement Marketing* Responsible for the submitting requested information for pharmacy to Revenue Cycle, Accounting, Administration* Performs physician and patient correspondence as necessary to promote positive relationships* Responsible for representing department as deemed necessary State and Federal updates Special events Other Represents the department through participation in local professional associations and community activities, etc.* Performs any and all other duties which may be required to assure proper administration and management of the department* Other duties as assigned

JOB REQUIREMENTS:

POSITION EDUCATION/ QUALIFICATIONS:* Registered with Texas State Board of Pharmacy in good standing, Associate or Bachelor Degree preferred* Have a working knowledge of Cerner* Have a working knowledge of PharmNet* Must be able to be sensitive to cultural and bilingual issues* Ability to read, write and speak English JOB KNOWLEDGE/EXPERIENCE:* Minimum five (5) year experience with medications, preferably in a hospital setting.* Demonstrates ability to understand and correct national drug codes* Can follow the Chargemaster process and problem solve regarding medication dosages and how they are billed.* Communicates between revenue cycle and pharmacy* Performs Chargemaster audits as needed to communicate necessary changes.* Modifies the charge master as necessary, according to guidance from director* Knowledge of regulatory requirements (state, federal other relevant area)* Organizational skills are required along with good written and verbal communication skills* Ability to communicate clearly and concisely with all levels of management including: accounting, administration, and leadership.



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Rx Revenue Cycle Coordinator

Doctor's Hospital At Renaissance