High-CTR: Pharmacy Business Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
WVU Medicine
High-CTR: Pharmacy Business Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
Job Description
Pharmacy Business Coordinator - Home Infusion - Billing & Revenue Cycle at WVU Medicine
Role Overview
The Pharmacy Business Coordinator plays a critical role in the home infusion pharmacy setting at WVU Medicine. This position is responsible for ensuring the smooth operation of the revenue cycle, focusing on payer discussions, financial audits, and compliance with third-party payer regulations. The coordinator will work closely with insurance companies, patients, and internal teams to optimize reimbursement and provide excellent customer service. This role requires a strong understanding of pharmacy operations, revenue cycle management, and the complexities of the healthcare reimbursement landscape.A Day in the Life
A typical day for the Pharmacy Business Coordinator may involve:- Conducting payer discussions to negotiate favorable reimbursement rates.
- Performing in-house financial audits to identify areas for improvement.
- Monitoring payer performance compliance and addressing any discrepancies.
- Conducting prepayment claims audits to prevent billing errors.
- Managing CMS CERT audits and ensuring compliance with regulations.
- Overseeing CMS Fraud, Waste, & Abuse audits to maintain ethical standards.
- Auditing third-party payer compliance to ensure accurate billing and reimbursement.
- Providing customer support to patients and resolving any billing-related issues.
- Preparing reports on key performance indicators (KPIs) related to revenue cycle management.
- Gathering and documenting patient demographics, insurance information, and needs assessments.
- Contacting insurance companies to verify eligibility and benefits for requested services.
- Performing medical necessity screenings as required by third-party payers.
Why Morgantown, West Virginia?
Morgantown offers a unique blend of small-town charm and big-city amenities. As the home of West Virginia University, Morgantown boasts a vibrant cultural scene, a thriving economy, and a diverse population. The city is surrounded by beautiful natural landscapes, providing ample opportunities for outdoor recreation. Morgantown also offers a low cost of living compared to other major metropolitan areas, making it an attractive place to live and work. WVU Medicine is one of the largest employers in the region, providing stability and growth opportunities for its employees.Career Path
The Pharmacy Business Coordinator role can serve as a stepping stone to various career paths within WVU Medicine. Potential career advancements may include:- Revenue Cycle Manager: Oversee the entire revenue cycle process for the home infusion pharmacy.
- Pharmacy Manager: Manage the day-to-day operations of the pharmacy.
- Compliance Officer: Ensure compliance with all relevant regulations and policies.
- Financial Analyst: Analyze financial data and provide insights to improve profitability.
Salary & Benefits
The estimated salary range for the Pharmacy Business Coordinator position is $45,000 to $65,000 per year, depending on experience and qualifications. WVU Medicine offers a comprehensive benefits package that includes:- Comprehensive health insurance coverage.
- Generous paid time off (PTO) and holiday schedule.
- Retirement savings plan with employer matching contributions.
- Life insurance and disability coverage.
- Employee assistance program (EAP).
- Wellness programs.
- Professional development opportunities.
- Tuition reimbursement.
- Employee discounts.
- Flexible spending accounts (FSAs).
- Commuter benefits.
- Employee recognition programs.
WVU Medicine Culture
WVU Medicine is committed to providing high-quality healthcare services to the communities it serves. The organization fosters a culture of teamwork, respect, and continuous improvement. Employees are encouraged to collaborate, share ideas, and contribute to the overall success of the organization. WVU Medicine also values diversity and inclusion, creating a welcoming and supportive environment for all employees.How to Apply
To apply for the Pharmacy Business Coordinator position, please visit the WVU Medicine careers website and submit your application online. Be sure to include a cover letter and resume highlighting your relevant experience and qualifications.Frequently Asked Questions (FAQ)
- What are the minimum qualifications for this position?
The minimum qualifications include a Bachelor’s Degree in healthcare administration, business, finance, or a related field AND one (1) year of business OR healthcare-related experience; OR a High School Diploma or Equivalent AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND two (2) years of healthcare-related experience; OR an Associate’s Degree AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND one (1) year of healthcare-related experience.
- What are the preferred qualifications for this position?
The preferred qualifications include a PTCB Advanced Pharmacy Technician Certificate and three (3) years of experience working in a specialty pharmacy.
- What are the key responsibilities of the Pharmacy Business Coordinator?
The key responsibilities include conducting payer discussions, performing financial audits, monitoring payer performance compliance, conducting prepayment claims audits, managing CMS audits, providing customer support, and preparing reports.
- What skills are important for success in this role?
Important skills include knowledge of revenue cycle management, payer relations, claims adjudication, contractual claims processing, medical terminology, and the 340B Drug Discount Program.
- What is the salary range for this position?
The estimated salary range for this position is $45,000 to $65,000 per year, depending on experience and qualifications.
- What benefits does WVU Medicine offer?
WVU Medicine offers a comprehensive benefits package that includes health insurance, paid time off, retirement savings plan, life insurance, disability coverage, and more.
- What is the work environment like at WVU Medicine?
WVU Medicine fosters a culture of teamwork, respect, and continuous improvement. The organization values diversity and inclusion, creating a welcoming and supportive environment for all employees.
- What are the opportunities for career advancement at WVU Medicine?
Potential career advancements may include Revenue Cycle Manager, Pharmacy Manager, Compliance Officer, and Financial Analyst.
- How do I apply for this position?
To apply for this position, please visit the WVU Medicine careers website and submit your application online.
- Is relocation assistance available for this position?
Relocation assistance availability may vary. Please confirm during the interview process if relocation assistance is provided.
Locations
- Morgantown, West Virginia, United States
Salary
Estimated Salary Rangemedium confidence
49,500 - 71,500 USD / yearly
Source: ai estimated
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Revenue Cycle Managementintermediate
- Payer Relationsintermediate
- Claims Adjudicationintermediate
- Contractual Claims Processingintermediate
- Medical Terminologyintermediate
- 340B Drug Discount Program Knowledgeintermediate
- Financial Auditsintermediate
- Payer Performance Complianceintermediate
- Prepayment Claims Auditintermediate
- CMS CERT Auditsintermediate
- CMS Fraud, Waste, & Abuse Auditsintermediate
- Third Party Payer Complianceintermediate
- Customer Supportintermediate
- Report Generationintermediate
- Clerical Dutiesintermediate
- Pharmacy Operationsintermediate
- Data Analysisintermediate
- Insurance Verificationintermediate
- Pre-Certificationintermediate
- Authorizationintermediate
- Third Party Claims Managementintermediate
- Patient Interviewingintermediate
- Financial Counselingintermediate
- Benefits Processingintermediate
- Communicationintermediate
- Problem Solvingintermediate
- Documentationintermediate
- Data Entryintermediate
- Policy and Procedure Complianceintermediate
Required Qualifications
- Bachelor’s Degree in healthcare administration, business, finance, or related field AND one (1) year of business OR healthcare-related experience (experience)
- High School Diploma or Equivalent AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND two (2) years of healthcare-related experience (experience)
- Associate’s Degree AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND one (1) year of healthcare-related experience (experience)
- Knowledge of revenue cycle operations (experience)
- Knowledge of third party reimbursement procedures & regulations (experience)
- Understanding of payer relations (experience)
- Understanding of claims adjudication (experience)
- Understanding of contractual claims processing (experience)
- Understanding of medical terminology (experience)
- Understanding of the 340B Drug Discount Program (experience)
- Ability to provide customer support and resolve problems (experience)
- Proficiency in report generation and clerical duties (experience)
- Ability to perform pharmacy related functions in compliance with departmental policies and procedures (experience)
- Experience securing registration data based upon comprehensive data elements (experience)
- Experience with financial education/counseling (experience)
- Experience with insurance verification (experience)
- Experience providing clinical information for pre-certification, authorization and third party claims management (experience)
- Ability to interview patients and arrange alternate methods of payment (experience)
- Ability to calculate patient co-payments and deductibles based upon benefits processing (experience)
- PTCB Advanced Pharmacy Technician Certificate (Preferred) (experience)
- Three (3) years working in a specialty pharmacy (Preferred) (experience)
Responsibilities
- Conduct payer discussions to optimize reimbursement.
- Perform in-house financial audits to ensure accuracy and compliance.
- Monitor payer performance compliance to identify and address discrepancies.
- Conduct prepayment claims audits to prevent errors and fraud.
- Manage CMS CERT audits to ensure compliance with regulations.
- Oversee CMS Fraud, Waste, & Abuse audits to maintain ethical standards.
- Audit 3rd party payer compliance to ensure accurate billing and reimbursement.
- Maintain up-to-date knowledge of revenue cycle operations, third party reimbursement procedures, and regulations.
- Provide customer support and resolve problems related to customer inquiries.
- Complete reports and perform clerical duties to support the department.
- Perform pharmacy related functions in compliance with departmental policies and procedures.
- Draft various correspondence letters and send to referral sources when necessary.
- Gather and document demographics, insurance information, needs assessment, and other data as needed.
- Provide information and answers to patient/caregiver questions, referring to clinicians when appropriate.
- Identify patients requiring pre-certification or pre-authorization at the time services are requested.
- Enter pre-registration data using comprehensive data elements into the registration/billing system.
- Contact insurance companies or employers to determine eligibility and benefits for requested services.
- Perform medical necessity screening as required by third party payers.
Benefits
- general: Comprehensive health insurance coverage, including medical, dental, and vision.
- general: Generous paid time off (PTO) and holiday schedule for work-life balance.
- general: Retirement savings plan with employer matching contributions to secure your future.
- general: Life insurance and disability coverage for financial protection.
- general: Employee assistance program (EAP) for confidential support and resources.
- general: Wellness programs promoting physical and mental well-being.
- general: Professional development opportunities, including training and continuing education.
- general: Tuition reimbursement for eligible employees to advance their education.
- general: Employee discounts on various products and services.
- general: Flexible spending accounts (FSAs) for healthcare and dependent care expenses.
- general: Commuter benefits to help with transportation costs.
- general: Employee recognition programs to celebrate achievements and contributions.
- general: Competitive salary commensurate with experience.
- general: Opportunity to work in a leading academic medical center.
- general: Supportive and collaborative work environment.
- general: Access to state-of-the-art technology and resources.
- general: Opportunities for advancement within the organization.
- general: Employee referral program with bonus opportunities.
- general: On-site parking or transportation assistance.
- general: Dependent Care Options
Tags & Categories
Answer 10 quick questions to check your fit for High-CTR: Pharmacy Business Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now! @ WVU Medicine.
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High-CTR: Pharmacy Business Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
WVU Medicine
High-CTR: Pharmacy Business Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
Job Description
Pharmacy Business Coordinator - Home Infusion - Billing & Revenue Cycle at WVU Medicine
Role Overview
The Pharmacy Business Coordinator plays a critical role in the home infusion pharmacy setting at WVU Medicine. This position is responsible for ensuring the smooth operation of the revenue cycle, focusing on payer discussions, financial audits, and compliance with third-party payer regulations. The coordinator will work closely with insurance companies, patients, and internal teams to optimize reimbursement and provide excellent customer service. This role requires a strong understanding of pharmacy operations, revenue cycle management, and the complexities of the healthcare reimbursement landscape.A Day in the Life
A typical day for the Pharmacy Business Coordinator may involve:- Conducting payer discussions to negotiate favorable reimbursement rates.
- Performing in-house financial audits to identify areas for improvement.
- Monitoring payer performance compliance and addressing any discrepancies.
- Conducting prepayment claims audits to prevent billing errors.
- Managing CMS CERT audits and ensuring compliance with regulations.
- Overseeing CMS Fraud, Waste, & Abuse audits to maintain ethical standards.
- Auditing third-party payer compliance to ensure accurate billing and reimbursement.
- Providing customer support to patients and resolving any billing-related issues.
- Preparing reports on key performance indicators (KPIs) related to revenue cycle management.
- Gathering and documenting patient demographics, insurance information, and needs assessments.
- Contacting insurance companies to verify eligibility and benefits for requested services.
- Performing medical necessity screenings as required by third-party payers.
Why Morgantown, West Virginia?
Morgantown offers a unique blend of small-town charm and big-city amenities. As the home of West Virginia University, Morgantown boasts a vibrant cultural scene, a thriving economy, and a diverse population. The city is surrounded by beautiful natural landscapes, providing ample opportunities for outdoor recreation. Morgantown also offers a low cost of living compared to other major metropolitan areas, making it an attractive place to live and work. WVU Medicine is one of the largest employers in the region, providing stability and growth opportunities for its employees.Career Path
The Pharmacy Business Coordinator role can serve as a stepping stone to various career paths within WVU Medicine. Potential career advancements may include:- Revenue Cycle Manager: Oversee the entire revenue cycle process for the home infusion pharmacy.
- Pharmacy Manager: Manage the day-to-day operations of the pharmacy.
- Compliance Officer: Ensure compliance with all relevant regulations and policies.
- Financial Analyst: Analyze financial data and provide insights to improve profitability.
Salary & Benefits
The estimated salary range for the Pharmacy Business Coordinator position is $45,000 to $65,000 per year, depending on experience and qualifications. WVU Medicine offers a comprehensive benefits package that includes:- Comprehensive health insurance coverage.
- Generous paid time off (PTO) and holiday schedule.
- Retirement savings plan with employer matching contributions.
- Life insurance and disability coverage.
- Employee assistance program (EAP).
- Wellness programs.
- Professional development opportunities.
- Tuition reimbursement.
- Employee discounts.
- Flexible spending accounts (FSAs).
- Commuter benefits.
- Employee recognition programs.
WVU Medicine Culture
WVU Medicine is committed to providing high-quality healthcare services to the communities it serves. The organization fosters a culture of teamwork, respect, and continuous improvement. Employees are encouraged to collaborate, share ideas, and contribute to the overall success of the organization. WVU Medicine also values diversity and inclusion, creating a welcoming and supportive environment for all employees.How to Apply
To apply for the Pharmacy Business Coordinator position, please visit the WVU Medicine careers website and submit your application online. Be sure to include a cover letter and resume highlighting your relevant experience and qualifications.Frequently Asked Questions (FAQ)
- What are the minimum qualifications for this position?
The minimum qualifications include a Bachelor’s Degree in healthcare administration, business, finance, or a related field AND one (1) year of business OR healthcare-related experience; OR a High School Diploma or Equivalent AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND two (2) years of healthcare-related experience; OR an Associate’s Degree AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND one (1) year of healthcare-related experience.
- What are the preferred qualifications for this position?
The preferred qualifications include a PTCB Advanced Pharmacy Technician Certificate and three (3) years of experience working in a specialty pharmacy.
- What are the key responsibilities of the Pharmacy Business Coordinator?
The key responsibilities include conducting payer discussions, performing financial audits, monitoring payer performance compliance, conducting prepayment claims audits, managing CMS audits, providing customer support, and preparing reports.
- What skills are important for success in this role?
Important skills include knowledge of revenue cycle management, payer relations, claims adjudication, contractual claims processing, medical terminology, and the 340B Drug Discount Program.
- What is the salary range for this position?
The estimated salary range for this position is $45,000 to $65,000 per year, depending on experience and qualifications.
- What benefits does WVU Medicine offer?
WVU Medicine offers a comprehensive benefits package that includes health insurance, paid time off, retirement savings plan, life insurance, disability coverage, and more.
- What is the work environment like at WVU Medicine?
WVU Medicine fosters a culture of teamwork, respect, and continuous improvement. The organization values diversity and inclusion, creating a welcoming and supportive environment for all employees.
- What are the opportunities for career advancement at WVU Medicine?
Potential career advancements may include Revenue Cycle Manager, Pharmacy Manager, Compliance Officer, and Financial Analyst.
- How do I apply for this position?
To apply for this position, please visit the WVU Medicine careers website and submit your application online.
- Is relocation assistance available for this position?
Relocation assistance availability may vary. Please confirm during the interview process if relocation assistance is provided.
Locations
- Morgantown, West Virginia, United States
Salary
Estimated Salary Rangemedium confidence
49,500 - 71,500 USD / yearly
Source: ai estimated
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Revenue Cycle Managementintermediate
- Payer Relationsintermediate
- Claims Adjudicationintermediate
- Contractual Claims Processingintermediate
- Medical Terminologyintermediate
- 340B Drug Discount Program Knowledgeintermediate
- Financial Auditsintermediate
- Payer Performance Complianceintermediate
- Prepayment Claims Auditintermediate
- CMS CERT Auditsintermediate
- CMS Fraud, Waste, & Abuse Auditsintermediate
- Third Party Payer Complianceintermediate
- Customer Supportintermediate
- Report Generationintermediate
- Clerical Dutiesintermediate
- Pharmacy Operationsintermediate
- Data Analysisintermediate
- Insurance Verificationintermediate
- Pre-Certificationintermediate
- Authorizationintermediate
- Third Party Claims Managementintermediate
- Patient Interviewingintermediate
- Financial Counselingintermediate
- Benefits Processingintermediate
- Communicationintermediate
- Problem Solvingintermediate
- Documentationintermediate
- Data Entryintermediate
- Policy and Procedure Complianceintermediate
Required Qualifications
- Bachelor’s Degree in healthcare administration, business, finance, or related field AND one (1) year of business OR healthcare-related experience (experience)
- High School Diploma or Equivalent AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND two (2) years of healthcare-related experience (experience)
- Associate’s Degree AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND one (1) year of healthcare-related experience (experience)
- Knowledge of revenue cycle operations (experience)
- Knowledge of third party reimbursement procedures & regulations (experience)
- Understanding of payer relations (experience)
- Understanding of claims adjudication (experience)
- Understanding of contractual claims processing (experience)
- Understanding of medical terminology (experience)
- Understanding of the 340B Drug Discount Program (experience)
- Ability to provide customer support and resolve problems (experience)
- Proficiency in report generation and clerical duties (experience)
- Ability to perform pharmacy related functions in compliance with departmental policies and procedures (experience)
- Experience securing registration data based upon comprehensive data elements (experience)
- Experience with financial education/counseling (experience)
- Experience with insurance verification (experience)
- Experience providing clinical information for pre-certification, authorization and third party claims management (experience)
- Ability to interview patients and arrange alternate methods of payment (experience)
- Ability to calculate patient co-payments and deductibles based upon benefits processing (experience)
- PTCB Advanced Pharmacy Technician Certificate (Preferred) (experience)
- Three (3) years working in a specialty pharmacy (Preferred) (experience)
Responsibilities
- Conduct payer discussions to optimize reimbursement.
- Perform in-house financial audits to ensure accuracy and compliance.
- Monitor payer performance compliance to identify and address discrepancies.
- Conduct prepayment claims audits to prevent errors and fraud.
- Manage CMS CERT audits to ensure compliance with regulations.
- Oversee CMS Fraud, Waste, & Abuse audits to maintain ethical standards.
- Audit 3rd party payer compliance to ensure accurate billing and reimbursement.
- Maintain up-to-date knowledge of revenue cycle operations, third party reimbursement procedures, and regulations.
- Provide customer support and resolve problems related to customer inquiries.
- Complete reports and perform clerical duties to support the department.
- Perform pharmacy related functions in compliance with departmental policies and procedures.
- Draft various correspondence letters and send to referral sources when necessary.
- Gather and document demographics, insurance information, needs assessment, and other data as needed.
- Provide information and answers to patient/caregiver questions, referring to clinicians when appropriate.
- Identify patients requiring pre-certification or pre-authorization at the time services are requested.
- Enter pre-registration data using comprehensive data elements into the registration/billing system.
- Contact insurance companies or employers to determine eligibility and benefits for requested services.
- Perform medical necessity screening as required by third party payers.
Benefits
- general: Comprehensive health insurance coverage, including medical, dental, and vision.
- general: Generous paid time off (PTO) and holiday schedule for work-life balance.
- general: Retirement savings plan with employer matching contributions to secure your future.
- general: Life insurance and disability coverage for financial protection.
- general: Employee assistance program (EAP) for confidential support and resources.
- general: Wellness programs promoting physical and mental well-being.
- general: Professional development opportunities, including training and continuing education.
- general: Tuition reimbursement for eligible employees to advance their education.
- general: Employee discounts on various products and services.
- general: Flexible spending accounts (FSAs) for healthcare and dependent care expenses.
- general: Commuter benefits to help with transportation costs.
- general: Employee recognition programs to celebrate achievements and contributions.
- general: Competitive salary commensurate with experience.
- general: Opportunity to work in a leading academic medical center.
- general: Supportive and collaborative work environment.
- general: Access to state-of-the-art technology and resources.
- general: Opportunities for advancement within the organization.
- general: Employee referral program with bonus opportunities.
- general: On-site parking or transportation assistance.
- general: Dependent Care Options
Tags & Categories
Answer 10 quick questions to check your fit for High-CTR: Pharmacy Business Coordinator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now! @ WVU Medicine.
10 Questions
~2 Minutes
Instant Score
Related Books and Jobs