Pharmacy Charge Specialist

Nuvance HealthDanbury, Connecticut

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Overview

Schedule

Full-time

Career level

Senior-level

Benefits

Career Development

Job Description

Description

Position at Nuvance Health

Summary:

The Pharmacy Charge Specialist position is responsible for providing analytical support in all areas of system pharmacy-related charges and revenue. Responsible for the oversight and maintenance of the system Pharmacy CDM and related ancillary systems content according to government and third party payer regulations and guidelines. Monitors regulatory changes and payer requirements. Works closely with all revenue-producing areas to ensure accurate and compliant pharmacy charge capture.

Responsibilities:

Responsibilities

Responsibilities & Qualifications include:

Monitors and responds to Nuvance Health system-wide billing issues identified in the Cerner Patient Accounting application

Daily monitoring of the system EHR health information technology Pending Queue (Pending charges comprise medication orders that are administered differently than ordered, as well as intermittent and continuous orders that are administered without having products assigned).

Investigates and corrects excessive billing unit claims

Reviews and corrects all rejected charges that occur

Monitors and reviews the daily JW modifier approval report. If items are identified to be rejected from the report, then this person will be responsible for the appropriate crediting and rebilling of the medication in question

Coordinates CDM maintenance with the appropriate Revenue Integrity analyst. This would be in conjunction with the formulary review, leveraging appropriate technology platform

Conduct annual review of reimbursement codes (JCODES) and update the formulary accordingly

Keeps current with Pharmacy Billing Regulations for compliance

Assist in investigating and responding to Billing Audits

Supports data integrity through interaction with financial and outcomes systems and auditing verification

Participates and lead committees, work groups, process improvement efforts, and educational initiatives to improve pharmacy revenue integrity and pharmacy billing cycle

Conforms to hospital standards of performance and conduct, including those pertaining to patient rights, so that the best possible customer service and patient care may be provided

Other initiatives and tasks required per leadership team relevant to position

Other Information:

Working Conditions:

Manual: Some manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment:

Company: Nuvance Health

Org Unit: 1937

Department: Pharmacy Corp

Exempt: No

Salary Range: $21.49 - $41.73 Hourly

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FAQs About Pharmacy Charge Specialist Jobs at Nuvance Health

What is the work location for this position at Nuvance Health?

This job at Nuvance Health is located in Danbury, Connecticut, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.

What pay range can candidates expect for this role at Nuvance Health?

Candidates can expect pay range between $21.49–$41.73 for this role.

What employment applies to this position at Nuvance Health?

Nuvance Health lists this role as a Full-time position.

What experience level is required for this role at Nuvance Health?

Nuvance Health is looking for a candidate with "Senior-level" experience level.

What benefits are offered by Nuvance Health for this role?

Nuvance Health offers Career Development for this position. Actual benefits may vary depending on the employer's policies and employment terms.

What is the process to apply for this position at Nuvance Health?

You can apply for this role at Nuvance Health either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.