Overview:
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
EEO/AA/Disability/Veteran
Responsibilities:
340B Compliance and Auditing Assists in the monitoring and various tracking and reporting measurements to ensure compliance with the
program. Reviews reports on billing, reimbursement, revenue cycle and 340B eligibility that clearly
document utilization, savings, problem areas, exceptions, and/or discrepancies to pharmacy and
administrative leadership. Communicates to specialist and/or manager key metrics and improvement
actions to management. Ensures appropriate documentation and audit trail across areas of responsibility
Information Systems: Monitor and assist with issue resolution of all Craneware Application and /or any other
related CMS, CDM findings. Assist with integration information from the pharmacy chargemaster systeminto the 340B split-billing computer system. Monitors and assist with issue resolution with EPIC and all
associated Billing system to ensure charge capture and revenue cycle optimization.
. Education: Assist in development and dissemination of billing, reimbursement and revenue cycle and
340B quality assurance training for employees as appropriate. Assist in providing proactive education to
staff on policies and procedures billing management and 340B procedures. Expand professional
development through related classes and seminars, current publications, and regional /national association
membership participation Certified Coding Associate (CCA), Certified Professional Coder (CPC).
Leadership: Strive to consistently improve the overall efficiency, value, and internal support billing
compliance and the 340B program. Facilitate productive exchanges of information to improve programefficiency and promote program compliance. Provide data, information, and reports as needed to ensure
appropriate escalation to pharmacy and corporate leadership
Participates in departmental, organizational and/or health system committees related to pharmacy services
,medication procurement, finance and other hospital initiatives as appropriate
Qualifications:
EDUCATION (number of years and type required to perform the position duties):
Requires broad training in fields such as pharmacy technician, medical coding , compliance/auditing or similar
vocations generally obtained through completion of associate 's degree program. Medical Coding experience or
certification is highly desirable
EXPERIENCE (number of years and type required to meet an acceptable level of performance):
5-10 years experieince as a pharmacy technician, medical coding or related health care experience. Two years
experience in overseeing project or demonstrable administrative/leadership tasks
SPECIAL SKILLS: Must have excellent communication skills and the ability to prioritize and multitask /change tasks frequently and
quickly. Knowledge of drug products preferred. Knowledge of requirements for medical coding is recommended .
Must be competent with Microsoft Office applications, including Excel and Access. ACCOUNTABILITY (how this position is held accountable for such as goals achievement, budget adherence, or
other areas of accountability):
The 340B Program Billing Analyst is accountable to the 340B Program Integrity Manager for maintaining the
highest professional standards. The position ensures compliance with the vision, mission, values, HR standards
including but not limited to staffing standards as documented in the Attendance and Punctuality system . The position is responsible for monitoring 340B Program billing compliance, reporting potential issues and
creating tracking dashboard of progress/changes. Provides monthly variance reports to the the 340B team and
Corporate leadership as appropriate
COMPLEXITY (describe planning, problem solving, decision making, creative activity, or other special factors
inherent in the responsibilities of this position):
In personal and job-related decisions and actions, consistently demonstrates the values of integrity (doing the right
thing), patient-centered (putting patients and families first), respect (valuing all people and embracing all differences),
accountability (being responsible and taking action), and compassion (being empathetic).
The position requires a high degree of planning and discretion ensuring optimization and compliane with 340B
Program Standards and Medical Coding Standards. The position requires the ability to apply new ideas ,
knowledge and skills gained from experience and education to current situation.
LICENSURE/CERTIFICATION:
5-10 years experieince as a pharmacy technician, medical coding or related health care experience. Two years
experience in overseeing project or demonstrable administrative/leadership tasks