PHARMACY BILLING COMPL ANALYST
The University of Kansas Hospital - Kansas

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Work among the best. As integral members of the hospital’s multidisciplinary team, the Pharmacy staff continually improves its practices to keep the hospital at the forefront of medication care. In addition to being the best place to work, the hospital offers very competitive wages and an outstanding benefit package.

We currently have an opening for a Pharmacy Billing Analyst.

Responsibilities:
* Serves as the primary professional staff member in the Department of Pharmacy responsible maintenance of data production and collection systems used for patient billing and management reporting.
* Validation of ERX maintenance in order to ensure compliance with CDM/ERX Pharmacy Policy by performing ERX charge testing for all ERX changes in relation to charge fields and ensure proper documentation of all changes
* Analyze and verify individual patient charges for accuracy and completeness as requested by Audit and Compliance
* Evaluate charge changes for impact on revenue and report findings to appropriate parties
* Effectively uses the appropriate financial concepts and tools to analyze situations and make financial decisions that support the achievement of short and longer-term departmental objectives.
* Assists Director of Billing Compliance and Chargemaster Coordinator in organizing and implementing compliance initiatives related to Hospital billing in accordance with rules, regulations, laws and payer contractual requirements.
* Researches coding, coverage, medical necessity and other compliance issues for all payers related to new charges added to the charge master.
* Serves as primary resource to Patient Financial Services staff for reporting problems and denials on individual claims. Researches coding issues and recommends solution to account representative. Identifies source of problem and implements corrective action to insure that Charge Master is updated to prevent future rejections/denials and to insure accurate and expedient reimbursement.
* Completes routine audits and transaction testing to insure regulatory billing compliance and to support departmental compliance initiatives.
* Serves as liaison between Finance, Charge Audit, and Pharmacy departments to inform of changes in Charge Master and changing protocol in clinical departments.
* Ensuring the synchronization of pharmacy charge data between all charging systems including SMS, McKesson, and O2.
* Complies with Medicare/Medicaid rules and regulations
* Troubleshoot system processes and jobs, using log files, system utilities and operating system to diagnose and resolve problems.
* Assist in coordination in the development, daily operations and implementation of the CDM/ERX Pharmacy Policy through teamwork with the IT Pharmacy staff.

Requirements:
* Bachelor's Degree in Business or equivalent is required - Eight years of relevant experience will be considered in lieu of the Bachelor Degree
* 3 years experience in Hospital Billing, Medical Records or Charge Audit environment.
* Demonstrated PC skills.
* Demonstrated knowledge of Hospital Charging procedures and protocol. Demonstrated general knowledge of billing and coding rules and regulations for governmental and managed care payers.
* Experience with coding and Charge Description Master maintenance is desirable. Excellent analytical, critical thinking and problem solving skills.
* Ability to communicate clearly and use good judgment.
* Ability to work in a multi-focused environment.
* Ability to maintain patient and compliance information in strict confidence.

The University of Kansas Hospital - 22 months ago - save job - - block
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