Clinical Pharmacy Coordinator

Overview

 

This Pharmacy Business Coordinator will ensure optimal revenue capture for pharmaceuticals across the Cone Health Enterprise.  This position will:

• Serve as a liaison between pharmacy, clinical specialties, EPIC Willow, and the Revenue Cycle Team to support medication billing compliance and financial performance for hospital and professional based billing systems.
• Identify and prioritize opportunities to optimize pharmacy revenue across the enterprise.
• Provide financial analysis and education to site and system stakeholders to drive optimal pharmacy revenue capture.
• Serve as a system expert on medication-related compliance billing and charging topics.
• Develop policies and/or guidelines to improve revenue capture, integrity, and compliance.
• Communicate findings to management and oversee implementation of approved recommendations to ensure appropriate revenue capture.

Talent Pool: Allied Health

Responsibilities

 

 

• Support financial analysis and auditing of formulary initiatives for Pharmacy and Therapeutics Committee.
• Collaborate with physicians, clinicians, and other leaders to support financial analysis and auditing of the Clinical Value Optimization Committee recommendations and initiatives.
• Develop quality metrics and audit methodologies to drive accuracy and first-time quality for all HCPCS/CPT codes, revenue codes, billable units, modifiers, etc.
• Performs monthly analysis of revenue capture, denials, identifies and communicates causes, and implements action plans to resolve in a timely manner.
• Assist with writing denial letters.
• Reviews, analyzes, and implements process improvements in operational areas related to billing compliance and payer contracts.
• Actively research and stay current with important billing and revenue related compliance and optimization topics to guide organizational decisions.
• Participate in teaching activities with students and residents.

Qualifications

 

EDUCATION:

BS Pharmacy or PharmD degree required.

Master's degree in pharmacy, business, or other health-related discipline preferred.

ASHP-Accredited PGY1 Pharmacy Residency preferred.

 

EXPERIENCE:

REQUIRED

At least 3 years or equivalent of hospital pharmacy experience.

 

PREFERRED

Understanding of medication billing related to IPPS and OPPS.

EPIC hospital software experience.

 

LICENSURE/CERTIFICATION/REGISTRY/LISTING:

REQUIRED

Current active license to practice pharmacy in North Carolina, or eligible to obtain North Carolina pharmacy license within four (4) months of hire.

Completion of ASHP Pharmacy Revenue Cycle certification (within 2 months of start).

Completion of EPIC training classes as required (within 4 months of start).

 

PREFERRED

BLS (CPR)-American Red Cross or AHA Healthcare Provider