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MO-SSM Health St. Joseph Hospital - St. Charles

Worker Type:

Regular

Job Highlights:

Primary Location: St Louis Region

Schedule (PRN, Part-time, Full-time)        Full-time

Shift Days, 8-hour, Hybrid 

Shift start and end times       9-5:30pm        

Days of the week       Monday-Friday       

Weekend Rotation?  No     

Job Summary:

Responsible for the timely and accurate billing of medication claims submitted through the electronic health record. Works with other departments to design, implement and evaluate billing processes and workflows that pertain to medication charges.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

Responsible for financial reporting on behalf of pharmacy services, including but not limited to accounts receivable management, month-end close, yearly financial reporting and compliance (serving as FWA and PBM contracting compliance officer).Verifies to ensure that dispensed high-cost medication products have been accounted for and reconciled with medication charges in the electronic health record.Evaluates the effectiveness of the billing process and introduces improvements as necessary. Research's and resolves medication charging errors, and rebills charity medications where applicable and in compliance with all prescription benefit management (PBM) and Health Resources and Services Administration (HRSA) guidelinesOversees billing of departments and external organizations. Verifies accurate billing during electronic health record (EHR) downtime. Assists auditors to verify accurate patient billing or prepare for appeal audits. Maintains competency in medication billing regulations, policy and guidance.Maintains a log of invoices received by outside vendors, processes in the invoice processing system, creates the appropriate invoice approval paperwork and allocates the invoice amount to the appropriate pharmacy sub-account.Responsible for PBM contracting including implementation, updating, and compliance. Serve as the HIPAA privacy policy officer and assist manager as applicable in any pharmacy or business licensing management including but not limited to National Council For Prescription Drug Programs accreditation, Medicaid and Medicare renewals, and applicable tax forms.Performs other duties as assigned.

EDUCATION

Bachelor's degree or equivalent years of experience and education

EXPERIENCE

No experience required

PHYSICAL REQUIREMENTS

Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.Frequent keyboard use/data entry.Occasional bending, stooping, kneeling, squatting, twisting and gripping.Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.Rare climbing.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS
 
State of Work Location: Illinois

    Pharmacy Technician, Registered - Illinois Department of Financial and Professional Regulation (IDFPR)    And        FUTURE - Pharmacy Technician, Registered within 2 months - Illinois Department of Financial and Professional Regulation (IDFPR)        Or        IL Registration Application Process Complete At Time Of Hire - Illinois Department of Financial and Professional Regulation (IDFPR)    And        Certified Pharmacy Technician (CPhT) - Pharmacy Technician Certification Board (PTCB)        Or        Certified Pharmacy Technician (ExCPT/CPhT) - National Healthcareer Association (NHA)

 
State of Work Location: Missouri

    Pharmacy Technician - Missouri Division of Professional Registration    Or        MO Registration Application and Finger Print Process Complete AT TIME OF HIRE             -             Missouri Division of Professional Registration        And        FUTURE - Pharmacy Technician, Registered within 6 months - Missouri Division of                 Professional Registration

 
State of Work Location: Oklahoma

    Technician - Oklahoma State Board of Pharmacy

 
State of Work Location: Wisconsin

    Pharmacy Technician, Registered - Wisconsin Department of Safety and Professional Services     Or        WI Registration Application Process Complete AT TIME OF HIRE - Wisconsin Department             of             Safety and Professional Services        And        FUTURE - Pharmacy Technician, Registered within 6 Months - Wisconsin Department of             Safety             and Professional Services

Work Shift:

Day Shift (United States of America)

Job Type:

Employee

Department:

8753030033 System Pharmacy Community

Scheduled Weekly Hours:40

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.