Pharmacy Medication Assistance Revenue Cycle Representative

The University Of Iowa
US - Iowa - Iowa City
November 9, 2024

The University of Iowa Health Care, Department of Pharmaceutical Care, is seeking a full-time Pharmacy Medication Assistance Revenue Cycle Representative to join our team. The Revenue Cycle Representative is a financial position in the healthcare industry necessary for hospital and pharmacy billing practices. This position requires strong computer skills, a high level of attention to detail and a general knowledge of hospital and prescription billing practices. The Revenue Cycle Representative will work closely with other staff within the department to support pharmacy revenue management (e.g., benefits investigation, prior authorization support, copay assistance, patient assistance programs), complete routine pharmacy billing activities, and assist with operational workload (e.g., filling prescriptions, inventory management of repository and free drug programs) in PMAP.

Position Responsibilities:

Patient Revenue Management:
- Review pharmacy transactions and submit claims to insurance and/or third-party payors.
- Assist patients and staff with troubleshooting insurance claim issues, benefits investigation and enrollment of patients into pharmacy services (e.g., grants, financial assistance programs).
  - Communicate with patients, pharmacists and/ or providers to gather relevant demographic information.
  - Initiate and follow through for required prior authorizations.
  - Assist with copay/coinsurance assistance when applicable.
- Communicate with patients, the healthcare team and insurance companies for payment acquisition, pre-authorization and to resolve patient account inquiries.
- Appeal/troubleshoot claim payments and/or denials using available resources.
- Monitor compliance standards and policies to ensure UI Health Care receives full and accurate reimbursement for services in compliance with payor rules and regulations.
- Monitor repository and free drug program medications.
- Support patients in applying for grants and financial assistance programs.
- Provide the highest customer service experience for patients and providers.
Operations and Performance Standards:
- Utilize tools and processes to maximize the efficiency of the revenue cycle.
- Identify areas to improve the medication assistance process.
- Comply with established cash handling policies and procedures of the institution and department.
- Assist with the evaluation and implementation of new products/technology.
- Assist with the evaluation and implementation of new policies and procedures.
- Participate in standard pharmacy operations as the need arises.
Reporting:
- Analyze and prepare routine reports to identify trends and aid in making financial decisions.
- Report discrepancies found during report analysis.
- Document activities required by accrediting agencies, payors and/or administration (i.e., workload statistics, phone statistics, etc.).
Communication/Training:
- Communicate with providers, payors, patients, co-workers, supervisors and departments to resolve revenue cycle issues.
- Understand the importance of effective business communication and maintaining professionalism in difficult situations.
- Assist with maintaining resource documents for PMAP.
- Participate in orientation of pharmacy technicians, pharmacists, pharmacy residents and others within the department on pharmacy billing practices.
Other duties as assigned.

Education Requirements:

Completion of a bachelor's degree or equivalent combination of education and experience.
Successful completion of the pharmacy technician certification exam within twelve months of the start of employment.
Must be registered with Iowa Board of Pharmacy prior to commencing employment.

Experience Requirements:

Previous experience in customer service.
Experience and proficiency with computer software applications (i.e., Microsoft Office Suite - Word, Excel, Outlook, PowerPoint) or comparable programs.
Strong attention to detail and proven ability to gather and analyze data and keep accurate records.
Self-motivated with initiative to seek out additional responsibilities, tasks and projects.
Effective verbal and written communication skills, active listening skills and the ability to maintain professionalism while handling difficult situations.
Demonstrate ability to follow policies and procedures while escalating issues as needed.
Familiarity with medical terminology.

Desired Qualifications:

Experience working in a complex hospital system is desirable.
Experience working in a collaborative team environment is desirable.
Pharmacy experience is desirable.
Basic knowledge of healthcare billing, experience working with insurance and/or federal and state assistance programs is desirable.
Working experience with multiple technology platforms (i.e., Epic, GE) is desirable.
Basic knowledge and understanding of the Health Insurance Portability and Accountability Act (HIPAA) is desirable.

Position and Application details:
In order to be considered for an interview, applicants must upload the following documents and mark them as a "Relevant File" to the submission:
• Resume
• Cover Letter

Job openings are posted for a minimum of 14 calendar days and may be removed from posting and filled any time after the original posting period has ended.
Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification. Up to 5 professional references will be requested at a later step in the recruitment process.
For additional questions, please contact Penni Berger at ***

Read the full job description and apply online on the recuiter's web-site

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