This position performs duties related to pharmacy billing activities such as recovery, analysis, and monitoring of billing related data, reporting and making adjustments to patients bills to ensure accurate, timely and appropriate charge capture and billing. Coordinates and assists in identifying and correcting potential billing mistakes and in identifying and developing reimbursement opportunities and improvements. Serves as a resource for customer stakeholders regarding pharmaceutical billing and charge capture practices.
Assists customer stakeholders in managing accurate and timely charge capture throughout the Pharmacy revenue cycle. Uses EHR, clinical applications, and system reports to monitor and evaluate patient records for the prevention of erroneous billing practices. Daily audits error reports in the medication billing system and makes corrections when issues are identified. Matches, corrects, and codes charges that do not transmit to the billing system via normal processes. Identifies and resolves problems with the medication billing system, as well as assists in the development and implementation of programs to improve and enhance service quality.
Works with System teams to ensure timely review of all pertinent regulatory and third-party payer billing requirements to assess their impact on the billing of pharmaceutical items through pharmacy charge capture systems. Assists various System teams to add, delete or modify the Cerner drug formulary based on regulatory changes or changes to Banner billing practices that could impact billing of medications.
Maintains an understanding of charging programs such as the CMS JW Modifier program. Corresponds with leadership team to notify them of changes that could affect billing practices.
Builds and maintains strong relationships to provide assistance, coordination, and education. Communicates and provides information as appropriate and performs audits of Pharmacy charges as deemed necessary. Facilitates communication and issue resolution across a diverse array of stakeholders concerning charging or billing issues in a courteous, accurate, complete, and timely fashion. Issues, problems and any resolution or action taken, if applicable, are reported to the supervisor.
Associates, or minimum of 2 years comparable experience required.
Experience with automated financial systems, CMS, CDM, J Codes and HCPCS. Demonstrates good oral and written communication skills and strong organizational skills. Strong spreadsheet and database skills required.
Experience working in a hospital with pharmacy billing experience strongly encouraged.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.
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