Pharmacy Business Support Specialist, Winston Salem

Advocate Health and Hospitals Corporation•Winston Salem, NC

7d•Onsite

About The Position

The Pharmacy Business Support Specialist role is a full-time position within the Retail Pharmacy - Pharmacy Business Operations department. This role is responsible for various financial and administrative tasks related to pharmacy claims, payments, receivables, and patient billing. The position is on-site at Piedmont Plaza 1 in Winston Salem and operates on a Monday-Friday schedule from 8 am to 5 pm.

Requirements

Registration or licensure with state board of pharmacy per state of employment requirements.
High school diploma or equivalent.
No work experience required.
Proficient with calculator, PC, scanner, and copy machine.
Proficient with Microsoft Excel, Word, and Outlook.
Proficient with Adobe Pro.
Ability to multi-task and be self-motivated.
Strong mathematical skills and the ability to perform accurate detailed work are a must.
Ability to work in an environment with interruptions and moderate noise levels.
Requires occasional walking, standing, and lifting up to 25 pounds of material.
May be required to occasionally stretch, bend, twist, squat, and kneel to perform job.
Must be able to perform manipulative skills such as writing, typing, and data entry into the computer system.
Must have use of both hands, be able to see clearly, and read small type such as that on some departmental forms and labels.
Must be able to speak and be understood by others to communicate effectively.
Must project a professional image and be team oriented.

Responsibilities

Reconciles pharmacy claims to third party and interdepartmental payments.
Tracks and reports payments, receivables, and bad debt.
Reviews EOB’s and reconciles bank deposits.
Manages documentation and assists in pharmacy financial assistance program processes.
Utilizes payer and banking portals to research payment denials and exceptions.
Contacts third party payers to resolve issues resulting in denials/underpayments.
Responds to payer requests for supporting documentation.
Communicates payment and remittance information to external billing agencies.
Submits manual claims, as necessary.
Monitors claim status to ensure proper payment is received.
Ensures that Medicare Part B documentation is completed and maintained to support compliant billing.
Provides billing compliance training for pharmacy staff.
Compiles relevant supporting documentation in response to payer audits.
Manages patient billing and receivables.
Generates patient invoice statements and processes payments.
Administers outpatient pharmacy charity care and extended payment programs.
Answers pharmacy billing phone line and assists patients with questions.
Assists with payer credentialing.
Compiles and submits necessary documentation.
Submits pharmacy invoices for payment.
Ensures pharmacy is invoiced properly and vendors are paid in a timely fashion.
Maintains financial data and generates monthly reports to support month-end accounting entries.
Produces ad hoc management reports as necessary.
Seeks ways to minimize waste and reduce cost.
Works within budget guidelines.

Benefits

Comprehensive suite of Total Rewards
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
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