Address
Form of workSummary:
Assist management and software programmers in designing and maintaining software requirements for pharmacy DMEPOS, immunization and specialty medication dispensing and billing by performing the following duties:
Duties:
- Work with programmers and senior management to design and maintain billing and coding rules within company’s medical billing software
- Monitor updates and changes to rules, regulations, and manuals maintained/reported by Centers of Medicare and Medicaid Services (CMS), and Local Coverage Determinations (LCD)
- Maintain company’s charge master, coding rules and files by payer type including Medicare, Medicaid and private payers contracted with participating RedSail pharmacies.
- Work and communicate with RedSail Technologies’ software programmers
- Monitor daily claims activity and assist with resolving claim rejections and denials
- Participate in company meetings which may require travel to corporate headquarters and other company locations
Qualifications:
- Must have Pharmacy Tech experience and/or medical DME billing and coding experience
- Must have a general understanding of dispensing and documentation requirements
- Must be able to effectively manage multiple priorities
- Must be a problem solver with the ability to identify and resolve discrepancies and errors
- Must have good communication, customer service and interpersonal skills
- Must have expertise in Excel and Word, with the ability to manage and maintain multiple detailed worksheets
Education/Experience:
- High school diploma or general education degree (GED)
- Certified Pharmacy Technician, desired
Language Ability:
- Ability to read and interpret Medicare and Medicaid regulations and Local Coverage Determination (LCD)
- Ability to write routine reports and correspondence
- Desired ability to speak English and Spanish
