CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.
Job Details:
The Business Unit Specialist is responsible for the set up and accuracy of patient management system revenue cycle related files. This role involves coding inventory, loading and/or verifying set up for payers, contracts and fee schedules in addition to other projects as assigned. The ideal candidate will have knowledge of home infusion, medical billing practices, and payer reimbursement guidelines, as well as strong communication and problem-solving skills. The position requires attention to detail, the ability to work independently, and proficiency with Microsoft 365. Must possess strong project management skills, solid analytical and problem-solving skills, and have meticulous attention to detail.
Responsibilities
Evaluates and documents department needs and all aspects of business processes both operational and financial, including current process analysis; and proposed revisions to optimize business processes.
Assist in designing and executing solutions that meet System's/Divisions' strategic objectives
Assures quality of information technology solutions and system upgrades through business case and application-level testing; validates test results to initial business needs.
Work with Information Services staff to design, test and deploy appropriate hardware solutions, connectivity requirements and interface solutions, as appropriate.
Play a key role in month end close operations.
Builds and maintains system maintenance files, i.e., fee schedules, inventory set up/pricing, new payers, etc.
Provide documentation and training as needed.
Provide service according to the expectations of policies/procedures and standards developed around the revenue cycle department.
Manage routine & special projects which may require oversight of other departments' work and coordination of a wide variety of functions.
Develop and maintain working relationships with Revenue Cycle departments, and external contacts as appropriate.
Maintain policies and procedures of the team / department as needed.
Identify departmental needs and report to management as appropriate
Meet deadlines and turnaround times set by department leadership.
Provide guidance to peers and serve as reference point for questions as needed.
Skills & Abilities
Good computer skills are a given, with expert industry knowledge.
Must possess strong project management skills, solid analytical and problem-solving skills, and have meticulous attention to detail.
Able to communicate technical information to non-technical people.
Must possess strong project management skills, solid analytical and problem-solving skills, and have meticulous attention to detail.
Requirements
Bachelor's degree in data management, Information Systems, Economics, Mathematics, Statistics, or a related field or at least five years relevant industry experience.
Experience in health care insurance or health care.
CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire.
CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.