1+ months

Pharmacy Billing and Reimbursement Coordinator

Los Angeles, CA 90006
  • Jobs Rated
Job Posting: We take pride in having the best, most passionate employees. Join our team and help prove that a dynamic, inclusive environment fuels innovation and makes a difference for the patients we care for. As a Pharmacy Billing and Reimbursement Coordinator you will have the opportunity to serve as a resource and liaison between with the Pharmacy Services, Physician Billing Services and Clinical Departments to ensure appropriate coding, billing, documentation and reimbursement of charges related to medication administration as well as from a compliance and reimbursement perspective. This position requires an enthusiastic, customer service focused, flexible, dedicated professional with a commitment to excellence. Essential Job Duties include: - Conducts reviews of medical records for claims, charges, documentation, and adjudication of payments for medications administered in physician offices within established timeframes - Identifies and communicates changes that impact coding, medication order templates including development of appropriate coding for new services and procedures provided by clinicians - Investigates and responds to questions regarding documentation and coding issues - Coordinates the review of medical records and financial accounts with coding department and providers to maximize reimbursement - Keeps apprised and provides up-to-date information regarding compliance and regulatory/payor requirements pertaining to the coding and reimbursement of medication administration

**Qualification Requirements/Preferences:**

Education Certifications/Licensure Experience Physical Abilities You must have a minimum of 5 years of experience in a professional billing setting reviewing and interpreting patient medical records using HCPCS, CPT and ICD-10 CM coding systems. You must have working knowledge of medical terminology and of computer systems, preferably EPIC, and computer programs such as Word, Excel and Outlook. Preferred candidates will have Certified Pharmacy Technician License and any of the following certifications: Certified Professional Coder (CPC) or Certified Coding Specialist Physician (CCS-P) or Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA) or Certified Coding Associate (CCA) by American Health Information Management Certification (AHIMA).

Language Skills:

Excellent verbal communication skills to include effective telephone dialogue skills. Ability to read, interpret documents, routine reports/correspondence, patient charts, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers and/or employees of the organization.

Mathematical Skills:

Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rates, ratios, and percentages.

Reasoning Ability:

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Physical Demands:

Ability to sit for long periods of time, computer use and answer telephones.

Working Conditions:

Organizational Expectations: Demonstrates behavior that supports the Cedars-Sinai Health System mission. Attends required orientation and training seminars. Meets production standards within established time requirements. Work product and performance meets quality standards. Demonstrates respect and positive interpersonal skills with patients, clients, the public, managers, and co-workersa team player. Maintains confidentiality of patient care and business matters. Observes time, attendance, and dress code standards. Protects the safety of others and of the physical plant and equipment, following institution policies, fire, safety and infection control regulations.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of employees classified in this job.


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Pharmacy Billing and Reimbursement Coordinator

Los Angeles, CA 90006

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Los Angeles, CA

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33rd2018 - Pharmacist
Overall Rating: 33/220
Median Salary: $124,170

Work Environment
Very Low
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