Pharmacy Accounts Auditor - Hybrid

Advocate Health and Hospitals Corporation • Macon, GA

13d • Hybrid

About The Position

Plans and performs charge capture reviews in accordance with proper billing practices. Collaborates with internal and external customers on billing and coding functions to determine billing accuracy and optimize revenue capture. Develops written reports documenting review findings and recommendations.

Requirements

• Pharmacy Technician registration with Georgia state board of pharmacy per state of employment requirements.
• PTCB or ExCPT certification.
• College degree or an equivalent combination of relevant education and/or experience required.
• Typically two years’ experience with or exposure to relevant billing systems i.e. EPIC/Encompass.
• Auditing and purchasing experience.
• Highly effective communication (written and verbal) and interpersonal skills
• Exceptional customer service, problem resolution and process development skills
• Demonstrated leadership skills such as delegation, team building, managing multiple priorities, problem solving, and decision making
• Ability to understand and become knowledgeable of pharmacy standards, policies, procedures, and Health Insurance Portability and Accountability Act (HIPAA) regulations
• Demonstrated ability to maintain confidentiality, take initiative, and to work independently with minimal supervision
• Must be detail-oriented with the ability to handle multiple demands simultaneously
• Basic math skills
• Strong background in medical terminology preferred
• Organizational skills and analytical ability to prepare reports and reconcile reports correctly
• Computer skills with Microsoft Office, email, internet access, electronic pharmacy management systems, and pharmacy ordering and inventory systems

Nice To Haves

• Life support training courses may be required dependent on department discretion

Responsibilities

• Maintains a comprehensive and current level of knowledge of new developments and issues related to coding, charge capture, accounting, and billing compliance in the healthcare environment
• Serves as a resource for department managers, staff, and administration to obtain information on guidelines and regulatory standards of coding and billing
• Recommends new policies, procedures, and strategies to streamline workflows and ensure department is meeting organizational objectives and goals
• Documents and/or reviews all data collected during the review, identifying all billing, coding, and documentation errors
• Reviews HCPCS and coding updates, as applicable
• Reviews clinical documentation to ensure accurate CPT/HCPCS code assignment and appropriate reimbursement
• Utilizes findings to develop and coordinate educational and training programs for specific functional areas for departmental staff
• Verifies the validity of data/reports used and generated and adheres to system policies and procedures
• Follows through to ensure that any critical corrective action is taken and evaluates efficiency of interventions
• Prepares management reports, spreadsheets, and executive summaries of review findings
• Plans scope of review and communicates plan with leadership

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree