Revenue Cycle Pricing Specialist - PharmScript (Passaic)

Compensation

: $91,400.00 - $141,030.00 /year *

Employment Type

: Full-Time

Industry

: Accounting



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JOB DESCRIPTION
The RCO Pricing Specialist ensures external and internal billing communications (inlcuding price quotes) are completed accurately and in a timely manner

Essential Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Research and respond to internal and external billing inquiries (e.g., status checks for prior authorizations, third party related errors) received via email portal, sales force, Mediprocity and any other portals
Triage and monitor communications to be answered by appropriate department supervisors / sites
Process / reprocess live claims and retroactive claims (including live claims from facility billers for status changes, partial completion rebills, hold requests from cost containment, and stat requests)
Manage price quote process including:
Distinguish between fee for service and per diem facilities.
Answer incoming calls, emails, and faxes for pricing for potential admissions to facilities, including itemized cost-outs for all medications when required by patients insurance
Assist facilities requesting pricing for current patients through facility or private pay in the event of non-coverage
Assist Client Services in preparing materials for cost containment for facilities (comparative insulin/inhaler prices, etc.)
Calculate dosing for medications given in weight form in order to give accurate pricing
Coordinate with clinical billing pharmacist to offer clinically appropriate alternatives for high cost medications
Assist controller on test pricing for NDCs for onboarding facilities in order to demonstrate cost savings switching to Pharmscript vs. other pharmacies

Competencies
Attention to detail
Collaboration Skills
Communication
Decision Making
Discretion
Performance Management
Problem Solving/Analysis
Reliability
Teamwork
Technical Capacity

Supervisory Responsibility
There is no supervisory responsibility for this position

Work Environment:
This position operates in a long-term care facility. This role may use standard office and/or pharmacy equipment such as computers, phones, photocopiers, filing cabinets, rolling carts, fax machines and etc. A large portion of
work shall be performed in the long-term care facility where the noise may be loud.

Physical Demand:
The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:
May sit or stand seven (7) to ten (10) hours per day
The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, crouch, walk, crawl intermittently
May be necessary to work extended hours as needed
May lift and/or move up to 25 pounds
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role

Additional Notes:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Travel
The is no travel expected for this position

Education and Experience
Qualifications/Experience/Education
High school degree
Able to work independently as well as in a diverse, team environment
Reliable, able to work under pressure and meet deadlines
Excellent communication skills, professional demeanor
Detail oriented, excellent organizational skills

Company Profile:
Behind every script there is a patient. And behind every thriving healthcare facility there is a seamless pharmacy experience. At PharmScript, we are healthcare professionals first. Through precision, persistence and innovation, we seek to earn the trust of providers, residents, patients, and their loved ones every day, with every delivery.

EEO Statement
PharmScript is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation and gender identity or any other status protected by federal, state or local law.
EO/Minorities/Females/Disabled/Veterans

Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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