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Form of workJob Description
Family Health Care is currently seeking applications for the position of Pharmacy 340B Claims Specialist!
General Function: This position functions at the highest level (III) in the series of Pharmacy Technician roles within Family Health Care. The individual in this role is a “work-leader” serving as the expert on prescription claims reimbursement and performing self-auditing for the pharmacy department. This individual will ensure prescription claim integrity by having advanced knowledge of claim requirements for the various pharmacy benefit managers (PBM) and shall use that information to identify areas of improvement by performing targeted claim audits and will provide education to the pharmacy staff on billing requirements, when needed.
Responsibilities:
- Acts as pharmacy claims auditor and will audit claims daily into order to track claims accuracy, trends, anomalies and other critical information to help BFHC ensuring appropriate reimbursement while mitigating organizational risk for claims remediations resulting from claim processing errors.
- Acts as pharmacy 340B claims auditor and audits claims on a scheduled basis into order to track 340B claims accuracy, trends, anomalies, and other critical information to help BFHC maintain 340B claim integrity while ensuring adherence to 340B policies, procedures, rules and regulations.
- Ensures timely and accurate billing/collections of all pharmacy charges and reimbursement activities through the use of reporting and reconciliation.
- Ensures integrity if financial reports and provides necessary reports to the finance department upon request.
- Assists the Chief Pharmacist and pharmacy staff in the research, development and implementation of new and existing pharmacy services.
Location(s): All Sites
Employment Type: Full Time
Exempt/Non-Exempt: Non-Exempt
Benefits: Competitive wage and excellent benefits package. FHC is an eligible organization for State and Federal Loan Repayment Programs.
Family Health Care is an Equal Opportunity Employer.
