Pharmacy Retail Home Infusion Billing Analyst

Sanford Health•Fargo, ND

1d•$19 - $31•Onsite

About The Position

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. 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.

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.
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.