REPORTING RELATIONSHIPS/SUPERVISORY RESPONSIBILITIES

Will report directly to the Director of Pharmacy. Will interact regularly with pharmacy staff, pharmacy business analysts, and corporate finance.

 

POSITION SUMMARY

This position will be responsible for ensuring timely and accurate payment to pharmacy for products and services. Additionally, the position will be responsible for monitoring, resolving, and preventing any issues that lead to non-payment.

ACCOUNTABILITIES

*All duties listed below are essential unless noted otherwise*

Cash posting and reconciliation of pharmacy claims via remittance detail, both electronic and manual, utilizing Central Pay and other mechanisms. Monitoring and resolution of non-payments and variances in remittance detail to optimize reimbursement. Develop and maintain controls, processes, and procedures to ensure prompt and accurate payment of pharmacy claims. Provides feedback to Director for staff education needed to improve billing and/or compliance issues. Responsible for maintenance of the Accounts Receivable reports to meet established A/R goals. Assist pharmacy staff with medical billing of medications. Maintenance of pharmacy charge accounts for patients, cross-charges within ProMedica, and refunds. Performs other duties as directed.