Pharmacy Audit/Reimbursement Specialist-LifeSpan Pharmacy - Indianapolis, United States - CarDon & Associates

    CarDon & Associates
    CarDon & Associates Indianapolis, United States

    1 month ago

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    Description
    LifeSpan Pharmacy, a CarDon & Associates partner, is now seeking a Pharmacy Audit/Reimbursement Specialist. Weekly pay and great benefits


    BASIC FUNCTION:

    • Primary responsibility is to work and respond to audit requests from various third parties
    • Secondary responsibility will be to keep up with audit/reimbursements trends to help with purchasing and formulary decisions.
    • This may include tasks in 3rd party reconciliation and deposits
    EDUCATION, QUALIFICATIONS,


    CREDENTIALS:

    • Indiana pharmacy technician license preferred but not required
    • Understanding of Medicare/Medicaid/Insurance pay types, billing codes, and brand/generic medications required
    • Working knowledge of Microsoft Excel and long-term care pharmacy applications such as FrameworkLTC, FrameworkECM, and Sage300 accounting software strongly preferred.
    • Multi-tasking and experience in leading a team is preferred.

    RESPONSIBLE TO:
    Billing Manager/Informatics Pharmacist


    ESSENTIAL FUNCTIONS:

    The Pharmacy Audit/Reimbursement Specialist must be able to perform each essential function effectively to be successful in this position.

    This is a hybrid remote position that may require months in the office before remote work, and then 1-2 office days/week thereafter


    • Audit Requests (40%)
    • Respond to audit requests in a timely manner with frequent updates to management.
    • Identify trends and provide feedback to team leads to ensure compliance from all departments. Reconciliation and Cash Posting (20%)
    • Reconciliation and Cash Posting o Reconciliation of 3rd Party Remits o Posting of Private Pay Payments
    • Maintaining & Balancing Daily Cash Flow Spreadsheet Collections and Customer Relations (10%) Maintains assigned facilities accounts receivable aging, investigating and resolving non-payment issues
    • Private Pay accounts receivable aging, collections
    • Third Party accounts receivable aging, collections, contract compliance Pre-billing and Billing (10%)
    • Reviews private pay statements for assigned facilities, giving past dues to collections, credit balances to supervisor or manager for investigation, and mailing out the remainder in a timely manner
    • Resolves questions and/or concerns from facilities regarding monthly statements, making corrections or adjustments as needed
    • Prepare price quotes as requested Special Pricing of Resident Accounts (10%)
    • Set up residents accounts appropriately
    • Monitor and review each account prior to month end review
    • Correspond special pricing changes to residents as required General Office (10%) Filing
    • Attends training as provided in order to improve self and quality of work
    • Audits Pulling necessary paperwork
    • Accepts other duties as assigned The preceding list of essential functions is not exhaustive and may be supplemented.

    KNOWLEDGE, SKILLS, AND ABILITIES:

    • Advanced computer skills, including moderate excel & adobe functions
    • Ability to exhibit effective verbal and written communication skills
    • Ability to understand and exhibit a willingness to perform new job processes
    • Attributes and Attitude Characteristics
    • Maintains high level of attendance and punctuality
    • Communicates in a positive and respectful manner with customers and internal team members
    • Exhibits a "team work" attitude o Supports LifeSpan's mission and high standard of customer service