Posting Note: This is an onsite, full time, hourly position. This position works within the Pharmacy Revenue Cycle Team to support all assigned pharmacy billing functions. Duties include manual review of identified billing claims through fatal edit reports, reviewing and resolving billing tickets, auditing charge master for appropriateness in built charges, and quarterly reviewing CMS changes in billing requirements. This position will also help develop and maintain SOPs to ensure pharmacy billing functions are optimized to changes in billing requirements. This position reports to the Director of Pharmacy Business Operations, and works closely with Revenue Cycle, and the 340B Team. Phoenix Children's has a great work culture, and we are looking for an individual with an emphasis on cultural fit, ability to continually learn, and has a “builder” mindset to develop and maintain pharmacy revenue cycle functions.
The Pharmacy Billing Specialist will serve as the point of contact for all medication billing related activities throughout the inpatient and ambulatory sites of care. Scope of work for this role may include the review of medication charges and revenues, research incomplete information related to billing errors/denials, audit existing medication charges, and develop/maintain billing workflows. This individual also ensures new medication billing rules and regulatory changes (CMS and payors) are assessed for compliance, timely processes invoices, and assists in the development of policies and procedures. The Pharmacy Billing Specialist primarily collaborates with Revenue Cycle teams and directly reports to the Director of Pharmacy Business Operations.