What are the responsibilities and job description for the Contract Specialist - Pharmacy position at Fairview Health Services?
Overview
As a member of the pharmacy team, the Contract Specialist manages and coordinates all financial information with third party plans to ensure contract and regulatory compliance. This position will have a strong knowledge of ambulatory pharmacy revenue cycle management and can skillfully use interpersonal, customer service, problem solving and collaboration skills to support and manage pharmacy revenue management activities. The Contract Specialist will also be responsible for new and existing Business and Contract analysis.
Responsibilities Job Description
- Using pharmacy revenue management metrics and standard operating procedures, analyze proposed contracts, addendums and product lines for financial impact
- Review, research and respond to payor issues for ambulatory pharmacy service line
- Maintain a database with all regulatory compliance information
- Partner with third party plans to ensure accuracy of their records, notifying them of any relevant changes to pharmacy operations / credentialing
- Act as a subject matter expert in third party regulations and billing guidelines as pertains to Medicare benefits, and primary, secondary and tertiary insurance claims. Assist in resolving any billing issues, verifying eligibility and escalating as appropriate.
- Other responsibilities as assigned including but not limited to : process improvement and trend analysis, quality assurance and research
Organization Expectations, as applicable :
Completes all required learning relevant to the role
Qualifications
Minimum Qualifications to Fulfill Job Responsibilities :
Required
Education
Experience
Preferred
Experience
EEO Statement
EEO / AA Employer / Vet / Disabled : All qualified applicants will receive consideration without regard to any lawfully protected status
Benefit Overview
Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information : https : / / www.fairview.org / careers / benefits / noncontract
Compensation Disclaimer
The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical.
