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Coordinator Pharmacy Revenue Integrity Job in Irving

Job Description

Summary:

The Coordinator, Pharmacy Revenue Integrity responsible for reviewing, auditing, and reporting on charge capture at the department level, completing charge reconciliation, analyzing and resolving claims’ denials and unbilled claims' issues, performing audits on department patient accounts, supporting Revenue Integrity initiatives on behalf of the department, and ensuring billing compliance.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Reviews, audits, and reports on departmental charge capture, performs charge reconciliation on a regular basis, and works closely with department staff on timely charge capture.
• Performs timely reviews of patient accounts and remittances for denials to determine root cause and appropriateness and leads corrective action plans.
• Analyzes and resolves claims' denials and unbilled claims, including posting debits and credits to patient accounts.
• Facilitates selection of patient encounters for review prior to and after patient billing for purposes of performing audits and verification of billing compliance.
• Performs various analysis and provides reports to determine trends, compliant billing, impact to net revenue, and other analytical requests pertaining to revenue cycle.
• Works in concert with Revenue Management Team members and Revenue Integrity team at the hospital to ensure timely gathering and reporting of applicable data.
• Interacts and works with Revenue Cycle departments (i.e., HIM, Patient Access, PFS, and Compliance) on revenue management initiatives and process improvement opportunities.
• Performs other duties, as assigned by Department Manager or Director.
• Potential for exposure to hazardous and toxic substances (including chemotherapeutic, cytotoxic drugs and cleaning solutions), sticks or cuts by needles and other sharp items.
• Risk 0 exposure category.
• Potential for musculoskeletal injuries if proper lifting and carrying techniques are not used.
• Potential exposure to biologic material when participating in direct patient care activities (e.g., patient education, code attendance).

Requirements:

• Bachelor’s degree in business or healthcare related field preferred
• Minimum of three (3) years working in healthcare, whether in a clinical or ancillary setting or a Revenue Cycle department, is highly preferred.
• Certified Pharmacy Technician license registered in the State of practice preferred. 

Work Schedule:

• TBD

Work Type:

Full Time

EEO is the law - click below for more information: 

https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf

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