Pharmacy Audit & Credential Coordinator (Remote)

Overview

Job Title:Pharmacy Audit & Credential Coordinator (Remote)

Reports to: Manager, Licensing & Credentialing

SUMMARY The Pharmacy Audit & Credential Coordinator (Remote) provides support to the Organization through various functions, including but not limited to coordinating and responding to third-party audits, maintaining pharmacy credentialing, and investigating third-party rejections.

ESSENTIAL FUNCTIONS

• Respond to third-party audits and review requests in a timely manner.
• File appeals for third-party audit appeals when appropriate.
• Coordinate the completion of audit documentation by pharmacies by reviewing all audit documentation for completeness and accuracy and submitting the documentation to the requesting third party by the deadline date.
• Completion of required information for various PBM’s, Government, and State Agencies for new pharmacy participation and updates for existing pharmacies.
• Responsible for maintaining active credentialing with all entities as required.
• Outreach to PBM’s to verify current contracted rate reimbursement, performing appeals when appropriate.
• Responsible for maintaining contracts/carrier codes in the third-party reconciliation system and auditing the financial aspect of claims.
• Investigate third-party rejections.
• Work closely with the Accounting/Finance Department to ensure all audit/pricing results are correctly reported and acknowledged.
• Perform other duties as assigned

EDUCATION AND EXPERIENCE

Basic Qualifications:

• Specialty pharmacy environment experience (Required).

Preferred Qualifications:

• Certified Pharmacy Technician registration or related experience working in a pharmacy (Preferred).
• Minimum 2-3 years of experience working in a pharmacy dispensing system (Preferred).

COMPETENCIES

• Strong communication, interpersonal, and organizational skills.
• Ability to interact and communicate with people over the phone, sometimes in stressful situations.
• Extremely detail-oriented and able to multi-task.
• Proficient in Microsoft Office.
• Must have a strong work ethic with time-management and problem-solving skills.
• Must be able to work both independently and as a member of a team.
• Must have initiative and excellent follow-up skills.
• Ability to coordinate multiple activities and tasks simultaneously in a fast-paced environment.

About Us

Do you want to make a meaningful difference in the quality of healthcare? Omnicell is empowering health systems and pharmacies to radically transform the way they manage medications, so that they can achieve the vision of the Autonomous Pharmacy. Thousands of hospitals, pharmacies, skilled nursing facilities and care homes trust Omnicell to provide continuous innovation. They need us to deliver solutions to meet the ever-evolving challenges of the healthcare landscape. We encourage creative problem solving and outside-of-the-box thinking that only a diverse, well-rounded workforce can bring.
Join us as we build on our powerful combination of advanced automation, predictive intelligence, and expert services to create a safer future for patients - one where medication errors are a thing of the past. You'll be joining an organization whose culture encourages individual development, rewards intellectual curiosity, and embraces an inclusive environment. Join our growing company and help shape the future at Omnicell.
Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.
All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, protected veteran status, or on the basis of disability.
Omnicell will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.