Pharmacy Technician Prior Authorization/VFC coordinator
SSM Cardinal Glennon Children's Hospital

Job Info

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It's more than a career, it's a calling.
MO-SSM Health Cardinal Glennon Children's Hospital

Worker Type:
Regular

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) guidelines
• Oversees 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.
• Works in a constant state of alertness and safe manner.
• 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.

Licenses / Certifications:

FUTURE - Certified Pharmacy Technician (CPhT) within 24 months - National Healthcareer Association (NHA), FUTURE - Pharmacy Technician, Registered within 2 months - Illinois Department of Financial and Professional Regulation (IDFPR), FUTURE - Technician within 3 months - Oklahoma State Board of Pharmacy

Work Shift:
Day Shift (United States of America)

Job Type:

Employee

Department:
39010010 Pharmacy

Scheduled Weekly Hours:
40

SSM Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

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