A position in a Banner Health pharmacy is one you can look forward to. Join an engaging environment of full service, high technology and experience a wide variety of responsibilities. You'll also see how important a pharmacy job is to our ability to make life easier for our patients. Come enjoy great challenges and build both your knowledge of the field and your analytical skills.
The Pharmacy Billing Specialist will perform compliance duties related to pharmacy billing activities, including analysis, monitoring, reporting and billing adjustments to ensure accurate, timely and appropriate charge capture and billing for JW Modifier medications. Coordinates and assists in identifying and correcting potential billing mistakes and in identifying and developing reimbursement opportunities and improvements. This position is an integral component of the revenue cycle process and must have strong analytical, problem solving, and customer relations skills.
The Pharmacy Billing Specialist is a part of a centralized team as you work with every entity of Banner. As a Pharmacy Billing Specialist you will have the opportunity to grow in the corporate world as there is many opportunity for advancement. This is a Day position with some weekends depending on the needs of the business.
Banner Pharmacy Services division provides excellent patient care across our entire continuum through convenient access, improved medication outcomes and innovative pharmacy practices. Banner Pharmacy Services will be recognized nationally as a clinical leader and trusted partner in proactively providing innovative pharmacy services through excellence in integration, care coordination, medication management and service to make a difference in people's lives. Banner is expanding its focus from being a hospital company to a clinical quality company focused on population health management. Clinical Pharmacy Services are also included in this robust new service line and are responsible for the management of the Banner formulary, development of standardized system wide clinical pharmacy services, and management of adverse drug event preventions. Clinical Pharmacy Services provides collaborative drug therapy management and educational interventions in patient care to optimize medication therapy, improve outcomes, promote wellness, and disease prevention.
POSITION SUMMARY This position performs duties related to pharmacy billing activities such as recovery, analysis, and monitoring of billing related data, reporting and making adjustments to patients' bills to ensure accurate, timely and appropriate charge capture and billing. Coordinates and assists in identifying and correcting potential billing mistakes and in identifying and developing reimbursement opportunities and improvements. Serves as a resource for customer stakeholders regarding pharmaceutical billing and charge capture practices.
CORE FUNCTIONS 1. Assists customer stakeholders in managing accurate and timely charge capture throughout the Pharmacy revenue cycle. Uses EHR, clinical applications, and system reports to monitor and evaluate patient records for the prevention of erroneous billing practices. Daily audits error reports in the medication billing system and makes corrections when issues are identified. Matches, corrects, and codes charges that do not transmit to the billing system via normal processes. Identifies and resolves problems with the medication billing system, as well as assists in the development and implementation of programs to improve and enhance service quality.
2. Works with System teams to ensure timely review of all pertinent regulatory and third-party payer billing requirements to assess their impact on the billing of pharmaceutical items through pharmacy charge capture systems. Assists various System teams to add, delete or modify the Cerner drug formulary based on regulatory changes or changes to Banner billing practices that could impact billing of medications.
3. Maintains an understanding of charging programs such as the CMS JW Modifier program. Corresponds with leadership team to notify them of changes that could affect billing practices.
4. Builds and maintains strong relationships to provide assistance, coordination, and education. Communicates and provides information as appropriate and performs audits of Pharmacy charges as deemed necessary. Facilitates communication and issue resolution across a diverse array of stakeholders concerning charging or billing issues in a courteous, accurate, complete, and timely fashion. Issues, problems and any resolution or action taken, if applicable, are reported to the supervisor.
5. Works independently to ensure accuracy with Pharmacy billing activities. Internal customers may include Pharmacy Directors, revenue cycle staff and Clinical IT.
Associates, or minimum of 2 years comparable experience required.
Experience with automated financial systems, CMS, CDM, J Codes and HCPCS. Demonstrates good oral and written communication skills and strong organizational skills. Strong spreadsheet and database skills required.
Experience working in a hospital with pharmacy billing experience strongly encouraged.
Additional related education and/or experience preferred.
What might draw you to Banner Health? A great health care career, of course—and a great place to live, no matter what stage of life you’re in. With facilities across the West, there is a health care career for everyone, from big city living in the Phoenix area to friendly small towns in the mountains and plains. As one of the largest nonprofit health systems in the country, Banner Health offers both the stability that comes with success and the possibility of exploring new areas of the country. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages:
Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health.
Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible.
The size, success and growth of our system provide you with the stability and options to pursue your desired career path.
Competitive compensation and comprehensive benefits offer you options to complement your unique needs.