Pharmacy Charge Specialist (Remote)-FlexStaff TEMP

Northwell Health

14d • Remote

About The Position

The Pharmacy Charge Specialist position is responsible for providing analytical support in all areas of system pharmacy-related charges and revenue. Responsible for the oversight and maintenance of the system Pharmacy CDM and related ancillary systems content according to government and third party payer regulations and guidelines. Monitors regulatory changes and payer requirements. Works closely with all revenue-producing areas to ensure accurate and compliant pharmacy charge capture.

Responsibilities

• Monitors and responds to system-wide billing issues identified in the Cerner Patient Accounting application
• Daily monitoring of the system EHR health information technology Pending Queue (Pending charges comprise medication orders that are administered differently than ordered, as well as intermittent and continuous orders that are administered without having products assigned).
• Investigates and corrects excessive billing unit claims
• Reviews and corrects all rejected charges that occur
• Monitors and reviews the daily JW modifier approval report. If items are identified to be rejected from the report, then this person will be responsible for the appropriate crediting and rebilling of the medication in question
• Coordinates CDM maintenance with the appropriate Revenue Integrity analyst. This would be in conjunction with the formulary review, leveraging appropriate technology platform
• Conduct annual review of reimbursement codes (JCODES) and update the formulary accordingly
• Keeps current with Pharmacy Billing Regulations for compliance
• Assist in investigating and responding to Billing Audits
• Supports data integrity through interaction with financial and outcomes systems and auditing verification
• Participates and lead committees, work groups, process improvement efforts, and educational initiatives to improve pharmacy revenue integrity and pharmacy billing cycle
• Conforms to hospital standards of performance and conduct, including those pertaining to patient rights, so that the best possible customer service and patient care may be provided
• Other initiatives and tasks required per leadership team relevant to position

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees