Pharmacy Revenue Coordinator

Job Summary

Maintains departmental business systems and other business processes by ensuring accuracy and consistency with departmental requirements and regulatory agency standards. Accountable for tasks impacting organizational cash flow, compliance, patient satisfaction, and confidentiality. Responsible for analyzing, developing, and establishing charge processes and procedures throughout the organization to maintain charge integrity in compliance with Spectrum Health and other regulatory agencies.

Essential Functions

• Maintains revenue integrity and patient satisfaction by ensuring accuracy of all medication and/or supply prices and charge methodologies and maintaining interdepartmental revenue.
• Reviews and makes recommendations regarding charges / fee structure, revenue cycle business systems, or related processes. Researches patient access, coding and billing requirements when new procedures or regulatory changes are introduced.
• Develops charge reconciliation processes to assure all charges are entered for patients within the entire hospital system, collaborates with clinical staff on charge capture best practices, and performs internal and external audits to assure compliance with charge reconciliation processes.
• Communicates, collaborates, and acts as a consultant to others within and outside the department related to assigned tasks in order to facilitate continuity and coordination of services. Keeps upper management and other teams within the pharmacy and hospital system informed concerning progress / problems.
• Coordinates required updating of CPT / HCPCS codes, bill edits, third party payer changes or other revenue cycle regulatory requirements.
• Assists in the resolution of chargemaster revenue issues across the delivery system, such as patient access, billing or denials, and develops systems to proactively address trends.
• Facilitates the development of strategies for the evaluation and implementation of assigned tasks, such as recommended changes to business systems, reimbursement methodologies, or revenue cycle efficiencies, working collaboratively with teams / task forces / consultants.
• Responsible for monitoring workqueues and reports related to medication charges and government regulations. Uses department-specific knowledge and experience to identify medication charge and charting inconsistencies and ensures the proper resolution.
• Areas of focus could include:
• -Charge Work queue
• -Inbasket Charge Maintenance
• -Billing (Aeromed, IDB, Clinic)
• -Account Work queues
• -Price Updates
• -HCPCS Maintenance
• -Rover Work queues
• -Waste Reports and Charging
• -Med Build Request
• -Default NDC Updates
• -Invoice Submission
• -Chart Corrections
• -Compliance Corrections

Qualifications

• Required Bachelor's Degree or equivalent In related field

• 3 years of relevant experience different areas of the health system such as surgery, pharmacy, purchasing, billing, coding, reimbursement, supply chain, technology & information solutions, and/or finance. Required

• CRT-Pharmacy Technician, Certified (CPHT) - PTCB Pharmacy Technician Certification Board Pharmacy Upon Hire preferred Or
• CRT-Exam for the Certification of Pharmacy Technicians (ExCPT) - NHA National Healthcareer Association Upon Hire preferred
• LIC-Pharmacy Technician - STATE_MI State of Michigan Pharmacy Upon Hire preferred
• Ideal candidate will possess Full Pharmacy Technician License and National Certification, such as PTCB Certification as well as Pharmacy experience

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

• Optional identity theft protection, home and auto insurance, pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Blodgett Hospital - 1840 Wealthy St SE- Grand Rapids

Department Name

Administration - Pharmacy Business Services - GR

Employment Type

Full time

Shift

Variable (United States of America)

Weekly Scheduled Hours

40