
Pharmacy Operation Specialist
HUDSON, WIJobSeen todaySeen in employer's feed today
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Job overview
The Pharmacy Operations Specialist works with retail pharmacy business units and leaders to develop and implement workflows for outpatient retail pharmacy billing and reconciliations. The role collaborates with finance, pharmacy leaders, patients, and vendors to ensure charges and sales are billed, invoiced, and paid correctly. It also supports responses to audits and may involve travel to other pharmacies and affiliates as needed.
Skills & qualifications
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Full job description
JOB REQUIREMENTS: The Pharmacy Operations Specialist works with retail pharmacy business units and their respective leaders to develop and implement successful workflows for outpatient retail pharmacy professional billing and reconciliations. The Pharmacy Operations Specialist will collaborate with HealthPartners finance, pharmacy leaders, patients, and external vendors to ensure charges and sales are correctly billed, invoiced, and paid. In addition, the Pharmacy Operations Specialist will support pharmacy operations in responding to external and internal third party, regulatory, and compliance audits. Role may include traveling to other HealthPartners Pharmacies and its affiliates as needed. Essential Duties: Manage various professional billing work queues for all HealthPartners retail pharmacies. Review patient pharmacy accounts to ensure that charges and payments are accurate and obtains necessary information and records to research and resolve account errors. Communicate with insurance companies on behalf or patients to process claims and help resolve billing issues. Provide feedback to pharmacy team of incorrect or inaccurate processing of claims or financial transactions of procedures. Coordinate the write-off of uncollected or uncollectible pharmacy claims. Verify, audit, and reconcile claims and payments in the system for all HealthPartners retail pharmacies. Responsible for the coordination and maintenance of non-adjusted third-party plans and third-party reconciliation software Analyze accounts receivable balances and revenue variations. Travel to other HealthPartners Pharmacies and its affiliates to conduct audits when appropriate and/or required. Develop and maintain audit tools, assist in defining reports and present summaries to key stakeholders, including recommendations for corrective action and follow up. Communicate with patients to address patient questions/concerns regarding patient statements. Maintain appropriate confidentiality of information in accordance with policies. Work directly with pharmacy system vendors and/or pharmacy leader on problem identification and resolution. MINIMUM QUALIFICATIONS: Minimum of three years pharmacy operations experience as a Pharmacy Technician, pharmacy purchasing and inventory management in a retail pharmacy setting Experience with analyzing and reporting data to identify issues, trends, or expectations to drive improvement of results and find solutions Certified Pharmacy technician or equivalent program certificate Certification through the Pharmacy Technician Certification Board (PTCB) PREFERRED QUALIFICATIONS: Undergraduate Degree... For full info follow application link. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/0A5F67E007154292
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