Pharmacy Retail Home Infusion Billing Analyst
About The Position
Responsible for functions related to pharmacy coding and billing; participate in the resolution of pharmacy billing issues. Ensure that all pharmacy processes are completed in a timely manner and that projected incoming revenue is captured and reconciled against prescription records. Reviews and completes coding, claims, and denials for medications, supplies, and diagnosis within pharmacy. Maintains payer database, adding new payers when needed and assigning a pricing contract. Will work with payers as needed to determine eligibility. Evaluates provider database for new providers ensuring all license information is complete and correct. Assess pharmacists' progress notes for proper documentation. Monitors denials and claims to assess outstanding accounts receivable. Stay current on changing payer rules by subscribing and reviewing payer updates and home infusion industry magazines and listservs. Assist with statistical reports as requested and on a weekly, monthly, quarterly and annual basis. May provide consultation for hospital-based ground services. Utilize analytic software to build custom reports for AR or denials.
Requirements
- Associate's degree in health care or business related field required.
- Minimum of three years experience in pharmacy and medical billing.
Nice To Haves
- Bachelor's degree preferred.
- In lieu of education, leadership may accept 4 years of appliable experience.
- Certified pharmacy technician, coder, or medical biller preferred.
Responsibilities
- Reviews and completes coding, claims, and denials for medications, supplies, and diagnosis within pharmacy.
- Maintains payer database, adding new payers when needed and assigning a pricing contract.
- Works with payers as needed to determine eligibility.
- Evaluates provider database for new providers ensuring all license information is complete and correct.
- Assesses pharmacists' progress notes for proper documentation.
- Monitors denials and claims to assess outstanding accounts receivable.
- Stays current on changing payer rules by subscribing and reviewing payer updates and home infusion industry magazines and listservs.
- Assists with statistical reports as requested and on a weekly, monthly, quarterly and annual basis.
- May provide consultation for hospital-based ground services.
- Utilizes analytic software to build custom reports for AR or denials.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
