Pharmacy Business Support Specialist

38500 Retail Pharmacy - Pharmacy Business OperationsFull timeYes40

M-F 8am-5pm

The requirement for a Phar Tech license is not valid for this role. This should be optional because this role is administrative and not impacted by pharmacy knowledge.

Pay Range:

$21.85 - $32.80

Position Highlights:

• Full-Time; 40 hours/week, Monday-Friday, 8am-5pm
• Pharmacy Business Operations
• On-site at Piedmont Plaza 1 in Winston Salem

Major Responsibilities:

• Reconciles pharmacy claims to third party and interdepartmental payments.  Tracks and reports payments, receivables, and bad debt.  Reviews EOB’s and reconciles bank deposits. 
• Manage documentation and assist in our pharmacy financial assistance program processes.

• Utilizes payer and banking portals to research payment denials and exceptions.  Contacts third party payers to resolve issues resulting in denials/underpayments.  Responds to payer requests for supporting documentation.  
• Communicates payment and remittance information to external billing agencies.  
• Submits manual claims, as necessary.  Monitors claim status to ensure proper payment is received. 
• Ensures that Medicare Part B documentation is completed and maintained to support compliant billing.  Provides billing compliance training for pharmacy staff. 
• Compiles relevant supporting documentation in response to payer audits 
• Manages patient billing and receivables.  Generates patient invoice statements and processes payments.  Administers outpatient pharmacy charity care and extended payment programs. 
• Answers pharmacy billing phone line and assist patients with questions. 
• Assists with payer credentialing.  Compiles and submits necessary documentation. 
• Submits pharmacy invoices for payment.  Ensures pharmacy is invoiced properly and vendors are paid in a timely fashion. 
• Maintains financial data and generates monthly reports to support month-end accounting entries.
• Produces ad hoc management reports as necessary.
• Seeks ways to minimize waste and reduce costs.  Works within budget guidelines. 

Education and Experience:

• High school diploma or equivalent.

• Typically, 2 years’ experience required.
• Pharmacy Technician experience preferred.
• Financial analyst or staff accounting experience preferred.

Licensure, Registration, and/or Certification:

• No certification or license required.
• Registration or licensure with state board of pharmacy, per state of employment requirements preferred.
• Certification through Pharmacy Technician Certification Board (CPhT) or National Healthcareer Association (ExCPT) preferred.

Knowledge, Skills & Abilities Required:

• Proficient with calculator, PC, scanner, and copy machine.
• Proficient with Microsoft Excel, Word, and Outlook.
• Proficient with Adobe Pro.
• Ability to multi-task and be self-motivated.
• Strong mathematical skills and the ability to perform accurate detailed work are a must.
• Ability to work in an environment with interruptions and moderate noise levels.

Physical Requirements and Working Conditions:

• Primarily works within an administrative office environment.
• Requires occasional walking, standing, and lifting up to 25 pounds of material.
• May be required to occasionally stretch, bend, twist, squat, and kneel to perform job.
• Must be able to perform manipulative skills such as writing, typing, and data entry into the computer system.
• Must have use of both hands, be able to see clearly, and read small types such as that on some departmental forms and labels.
• Must be able to speak and be understood by others to communicate effectively.
• Must project a professional image and be team oriented.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive list of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.