Pharmacy Business Support Specialist

Position Highlights

• Full-Time; 40 hours/week, Monday-Friday, 8am-5pm
• Pharmacy Business Operations
• On-site at Piedmont Plaza 1 in Winston Salem

Major Responsibilities

• Reconciles pharmacy claims to third party and interdepartmental payments. Tracks and reports payments, receivables, and bad debt. Reviews EOB’s and reconciles bank deposits.
• Manage documentation and assist in our pharmacy financial assistance program processes.
• Utilizes payer and banking portals to research payment denials and exceptions. Contacts third party payers to resolve issues resulting in denials/underpayments. Responds to payer requests for supporting documentation.
• Communicates payment and remittance information to external billing agencies.
• Submits manual claims, as necessary. Monitors claim status to ensure proper payment is received.
• Ensures that Medicare Part B documentation is completed and maintained to support compliant billing. Provides billing compliance training for pharmacy staff.
• Compiles relevant supporting documentation in response to payer audits
• Manages patient billing and receivables. Generates patient invoice statements and processes payments. Administers outpatient pharmacy charity care and extended payment programs.
• Answers pharmacy billing phone line and assist patients with questions.
• Assists with payer credentialing. Compiles and submits necessary documentation.
• Submits pharmacy invoices for payment. Ensures pharmacy is invoiced properly and vendors are paid in a timely fashion.
• Maintains financial data and generates monthly reports to support month-end accounting entries.
• Produces ad hoc management reports as necessary.
• Seeks ways to minimize waste and reduce costs. Works within budget guidelines.

Education and Experience

• High school diploma or equivalent.
• Typically, 2 years’ experience required.
• Pharmacy Technician experience preferred.
• Financial analyst or staff accounting experience preferred.

Licensure, Registration, and/or Certification

• No certification or license required.
• Registration or licensure with state board of pharmacy, per state of employment requirements preferred.
• Certification through Pharmacy Technician Certification Board (CPhT) or National Healthcareer Association (ExCPT) preferred.

Knowledge, Skills & Abilities Required

• Proficient with calculator, PC, scanner, and copy machine.
• Proficient with Microsoft Excel, Word, and Outlook.
• Proficient with Adobe Pro.
• Ability to multi-task and be self-motivated.
• Strong mathematical skills and the ability to perform accurate detailed work are a must.
• Ability to work in an environment with interruptions and moderate noise levels.

Physical Requirements and Working Conditions

• Primarily works within an administrative office environment.
• Requires occasional walking, standing, and lifting up to 25 pounds of material.
• May be required to occasionally stretch, bend, twist, squat, and kneel to perform job.
• Must be able to perform manipulative skills such as writing, typing, and data entry into the computer system.
• Must have use of both hands, be able to see clearly, and read small types such as that on some departmental forms and labels.
• Must be able to speak and be understood by others to communicate effectively.
• Must project a professional image and be team oriented.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive list of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.