Pharmacy A/R Specialist - Outpatient

JOB DESCRIPTION:

The primary responsibility for the Pharmacy Accounts Receivable Specialist OP is for managing Pharmacy revenue and accounts receivable. This position will provide the necessary reports and process claims to optimize the financial performance for Outpatient Pharmacy revenue. 

The A/R Specialist is the principal point of contact and content manager of revenue for all UVMMC OP Pharmacy staff, payers and PBM’s (to include Medicare and Medicaid), Network affiliates, and to the revenue computer system vendor.  Best practice standards are managed through this role as well as providing support to the Network affiliates.  This position will provide alerts to management of trends with unfavorable reimbursements, manage a/r aging, and complete all cash reconciliation with Corporate Accounting.

This position will participate in routine pharmacy audits from payers, PBM’s, and external Auditors from Accounting.  The internal monitoring will focusing on proper documentation, timely submissions, and follow up to assure compliance and payments.  Routine monitoring of DIR fees (Direct and Indirect Remuneration fees) to identify areas of risk to the organization for revenue loss. 

EDUCATION:

Associate's degree or equivalent experience required with a focus in accounting/business management. Licensed/registered pharmacy technician in the State of Vermont required for entry into secure areas.

EXPERIENCE:

At least 3 years of experience with the claims reconciliation process to include a strong understanding of accounting practices.