340B Pharmacy Billing Analyst

NEW HAVEN, CT
Dec 12, 2019

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Job Description

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

Under the direction of the 340B Program Integrity Manager, the 340B Program Billing Analyst is responsible for assisting with auditing the functions and tasks related to the pharmaceutical billing /revenue cycle and 340B program for YNHHS. This includes identification and qualification of billable events eligible for 340B program.

EEO/AA/Disability/Veteran

Responsibilities

  • 1. 340B Compliance and Auditing Assists in the monitoring and various tracking and reporting measurements to ensure compliance with the program. Reviews reports on billing, reimbursement, revenue cycle and 340B eligibility that clearly document utilization, savings, problem areas, exceptions, and/or discrepancies to pharmacy and administrative leadership. Communicates to specialist and/or manager key metrics and improvement actions to management. Ensures appropriate documentation and audit trail across areas of responsibility
  • 2. Information Systems: Monitor and assist with issue resolution of all Craneware Application and /or any other related CMS, CDM findings. Assist with integration information from the pharmacy chargemaster system into the 340B split-billing computer system. Monitors and assist with issue resolution with EPIC and all associated Billing system to ensure charge capture and revenue cycle optimization.
  • 3. Education: Assist in development and dissemination of billing, reimbursement and revenue cycle and 340B quality assurance training for employees as appropriate. Assist in providing proactive education to staff on policies and procedures billing management and 340B procedures. Expand professional development through related classes and seminars, current publications, and regional /national association membership participation Certified Coding Associate (CCA), Certified Professional Coder (CPC).
  • 4. Leadership: Strive to consistently improve the overall efficiency, value, and internal support billing compliance and the 340B program. Facilitate productive exchanges of information to improve program efficiency and promote program compliance. Provide data, information, and reports as needed to ensure appropriate escalation to pharmacy and corporate leadership
  • 5. Participates in departmental, organizational and/or health system committees related to pharmacy services , medication procurement, finance and other hospital initiatives as appropriate

Qualifications

EDUCATION


Requires broad training in fields such as pharmacy technician, medical coding , compliance/auditing or similar vocations generally obtained through completion of associate 's degree program. Medical Coding experience or certification is highly desirable


EXPERIENCE


5-10 years experieince as a pharmacy technician, medical coding or related health care experience. Two years experience in overseeing project or demonstrable administrative/leadership tasks


LICENSURE


5-10 years experieince as a pharmacy technician, medical coding or related health care experience. Two years experience in overseeing project or demonstrable administrative/leadership tasks


SPECIAL SKILLS


Must have excellent communication skills and the ability to prioritize and multitask /change tasks frequently and quickly. Knowledge of drug products preferred. Knowledge of requirements for medical coding is recommended . Must be competent with Microsoft Office applications, including Excel and Access.


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Job Info

Job: 13922

Department: System Pharmacy Bus Practices
Category: PHARMACY
Sub Category: CLINICAL TECH
Status: Full Time Benefits Eligible
Shift: D/E
Hours: 40

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