Pharmacy Billing Coordinator - Ambulatory Pharmacy

Nationwide Children's Hospital • Columbus, OH

19h • Hybrid

About The Position

Overview: Schedule: Monday - Friday, daytime business hours Potential to be a hybrid position after successful onboarding, completion of training and probation period Job Description Summary: Leads outpatient pharmacy billing procedures, 340B rebate data submission and payment reconciliation, supports patient accounts and manages third party payor contracts. Collaborates to perform necessary administrative functions in support of the outpatient pharmacies and 340B program. Job Description: Essential Functions: Accountable for prescription claim surveillance and payment reconciliation. Serves as lead point of contact with third party reconciliation vendors. Reviews and analyzes prescription claim reimbursements. Submits and reconciles Medicare claims data for the Medicare Transaction Facilitator. Submits and reconciles claims data for the HRSA approved 340B rebate program. Collaborates to manage, report, and optimize financial performance including both revenue and expense. Assists in reviewing and managing outpatient prescription benefit manager contracts, including recredentialing needs. Oversees preparation of monthly reports related to prescription charges.

Requirements

• High school diploma or equivalent, required.
• Strong computer skills to include familiarity with Word, Excel, and Crystal Reports.
• Organizational skills and attention to detail with reconciliation duties.
• Ability to work independently.
• Strong communication skills.

Nice To Haves

• Bachelor’s degree or 5 years of related experience, preferred.
• Board of Pharmacy Technician License (Registered or Certified), preferred.
• Apexus Advanced 340B Operations Certification, preferred.
• Five years of billing, accounts receivable, or 340B experience, preferred.

Responsibilities

• Accountable for prescription claim surveillance and payment reconciliation.
• Serves as lead point of contact with third party reconciliation vendors.
• Reviews and analyzes prescription claim reimbursements.
• Submits and reconciles Medicare claims data for the Medicare Transaction Facilitator.
• Submits and reconciles claims data for the HRSA approved 340B rebate program.
• Collaborates to manage, report, and optimize financial performance including both revenue and expense.
• Assists in reviewing and managing outpatient prescription benefit manager contracts, including recredentialing needs.
• Oversees preparation of monthly reports related to prescription charges.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED