What are the responsibilities and job description for the Pharmacy Revenue Integrity Specialist position at Upstate Medical University?
Job Summary
The Pharmacy Revenue Integrity Specialist, under the supervision of the Pharmacy Revenue Integrity Manager, will be responsible for ensuring the accuracy and compliance of pharmacy billing practices by reviewing patient records, medication orders, and insurance claims to identify and correct potential pharmaceutical billing errors. Will be responsible for pharmacy billing work queues and the accurate submission or resubmission of pharmaceutical charges. Will collaborate with other departments to optimize pharmacy charging workflows and to decrease medication-related claim denials due to pharmaceutical charge errors. Will participate in any insurance or compliance audits, as requested, and will be responsible for maintaining relevant documentation and records. Will stay current with important billing and revenue related compliance.
Minimum Qualifications
Associate's degree and 3 years of relevant hospital pharmacy experience (in a hospital and/or State setting preferred), OR equivalent combination or education and experience. Prior hospital or pharmacy billing experience required. Excellent written/oral communication, ability to work independently and analytical and organizational skills required.
Preferred Qualifications
ASHP revenue integrity certification, knowledge of 340B billing requirements and experience with EPIC preferred.
Work Days
Rotating
Message To Applicants
Recruitment Office: Human Resources
The Pharmacy Revenue Integrity Specialist, under the supervision of the Pharmacy Revenue Integrity Manager, will be responsible for ensuring the accuracy and compliance of pharmacy billing practices by reviewing patient records, medication orders, and insurance claims to identify and correct potential pharmaceutical billing errors. Will be responsible for pharmacy billing work queues and the accurate submission or resubmission of pharmaceutical charges. Will collaborate with other departments to optimize pharmacy charging workflows and to decrease medication-related claim denials due to pharmaceutical charge errors. Will participate in any insurance or compliance audits, as requested, and will be responsible for maintaining relevant documentation and records. Will stay current with important billing and revenue related compliance.
Minimum Qualifications
Associate's degree and 3 years of relevant hospital pharmacy experience (in a hospital and/or State setting preferred), OR equivalent combination or education and experience. Prior hospital or pharmacy billing experience required. Excellent written/oral communication, ability to work independently and analytical and organizational skills required.
Preferred Qualifications
ASHP revenue integrity certification, knowledge of 340B billing requirements and experience with EPIC preferred.
Work Days
Rotating
Message To Applicants
Recruitment Office: Human Resources
