Job SummaryMaintains departmental business systems and other business processes by ensuring accuracy and consistency with departmental requirements and regulatory agency standards. Accountable for tasks impacting organizational cash flow, compliance, patient satisfaction, and confidentiality. Responsible for analyzing, developing, and establishing charge processes and procedures throughout the organization to maintain charge integrity in compliance with Spectrum Health and other regulatory agencies.Areas of focus to include:
Charge Work queue
Inbasket Charge Maintenance
Billing (Aeromed, IDB, Clinic)
Account Work queues
Price Updates
HCPCS Maintenance
Rover Work queues
Waste Reports and Charging
Med Build Request
Default NDC Updates
Invoice Submission
Chart Corrections
Compliance Corrections
Essential Functions
Maintains revenue integrity and patient satisfaction by ensuring accuracy of all medication and/or supply prices and charge methodologies and maintaining interdepartmental revenue.
Reviews and makes recommendations regarding charges / fee structure, revenue cycle business systems, or related processes. Researches patient access, coding and billing requirements when new procedures or regulatory changes are introduced.
Develops charge reconciliation processes to assure all charges are entered for patients within the entire hospital system, collaborates with clinical staff on charge capture best practices, and performs internal and external audits to assure compliance with charge reconciliation processes.
Communicates, collaborates, and acts as a consultant to others within and outside the department related to assigned tasks in order to facilitate continuity and coordination of services. Keeps upper management and other teams within the pharmacy and hospital system informed concerning progress / problems.
Coordinates required updating of CPT / HCPCS codes, bill edits, third party payer changes or other revenue cycle regulatory requirements.
Assists in the resolution of chargemaster revenue issues across the delivery system, such as patient access, billing or denials, and develops systems to proactively address trends.
Facilitates the development of strategies for the evaluation and implementation of assigned tasks, such as recommended changes to business systems, reimbursement methodologies, or revenue cycle efficiencies, working collaboratively with teams / task forces / consultants.
Responsible for monitoring workqueues and reports related to medication charges and government regulations. Uses department-specific knowledge and experience to identify medication charge and charting inconsistencies and ensures the proper resolution.
Qualifications
Required Bachelor's Degree or equivalent In related field
3 years of relevant experience different areas of the health system such as surgery, pharmacy, purchasing, billing, coding, reimbursement, supply chain, technology & information solutions, and/or finance. Required
CRT-Pharmacy Technician, Certified (CPHT) - PTCB Pharmacy Technician Certification Board Pharmacy Upon Hire preferred Or
CRT-Exam for the Certification of Pharmacy Technicians (ExCPT) - NHA National Healthcareer Association Upon Hire preferred
LIC-Pharmacy Technician - STATEMI State of Michigan Pharmacy Upon Hire preferred
Ideal candidate will be a Pharmacy Technician possessing Full Pharmacy Technician License and National Certification
Ideal candidate will also possess Inpatient Pharmacy, Billing, and Revenue Integrity experience
Ideal candidate will be a Team Player while also be able to work Independently, will be Detail Oriented, Self Driven, and possess Solid Communication Skills, both verbally and written
This is a Remote Position, Monday to Friday, 8 a.m. to 4:30 p.m., allowing some Flexibility in schedule
Revenue experience would be a plus
Primary LocationSITE - Blodgett Hospital - 1840 Wealthy St SE- Grand RapidsDepartment NameCorporate Admin - PharmacyEmployment TypeFull timeShiftDay (United States of America)Weekly Scheduled Hours40Hours of Work8 a.m. to 4:30 p.m.Days WorkedMonday to FridayWeekend FrequencyN/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.You may request assistance in completing the application process by calling 616.486.7447.People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.