Ohio State University
Pharmacy Audit and Reconciliation Coordinator
Ohio State University, Columbus, Ohio, United States, 43224
Pharmacy Audit and Reconciliation Coordinator page is loaded Pharmacy Audit and Reconciliation Coordinator Apply locations Medical Center Campus time type Full time posted on Posted 2 Days Ago job requisition id R123549 Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr-accessibleapplication@osu.edu . If you have questions while submitting an application, please review these frequently asked questions .
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Job Title: Pharmacy Audit and Reconciliation Coordinator Department: Retail Rx | OSU Outpatient Pharmacy CCCT
Scope of Position The Revenue Integrity Specialist optimizes the payment cycle for retail and specialty pharmacy claims. This role ensures accurate workflow of pharmacy accounts, reviews payments for accuracy, aligns collections with contracts, and follows up with insurance companies. The specialist secures third-party payments, ensures compliance with payer contracts, and maintains accurate secondary billing processes and vendor data feeds. They advocate for efficient claim resolution, provide proactive follow-up, and identify trends to ensure process accuracy. Additionally, they contribute to scalable process improvements, respond to and defend audit requests from commercial health plans/payors, and ensure the accuracy and completeness of claims to retain reimbursement. Position Summary This position assist s with revenue cycle related activities . These activities include but are not limited to reconciling payer remittances including unapplied cash, claim exceptions and partial pay understanding , payer denials and impact on revenue cycle , proactively communicate with onsite pharmacy staff, finance staff and insurance companies to resolve payment discrepancies . Advanced knowledge of, or experience with state, federal and PBM (Pharmacy Benefit Management/commercial health plans/payors) accreditation rules and regulations regarding pharmacy benefit and medical benefit claims billing . Th is position requires strong knowledge of Microsoft Excel, Microsoft Teams and other computer related skills. Minimum Qualifications For Hire:
Bachelor’s in Business, healthcare or related field or equivalent combination of education and related experience or 3 years experience as a pharmacy technician. Must be registered technician with the State of Ohio Board of Pharmacy and hold active PTCB/NHA certification prior to start date. On going:
PTCB certification and Board of Pharmacy registration as a Certified pharmacy technician must be maintained for continued employment. Additional Information:
Location: Ackerman Rd, 660 (0242) Position Type: Regular Scheduled Hours: 40
Shift:
Varying Shifts
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process. Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions . The university is an equal opportunity employer, including veterans and disability.
About Us
Each day, Buckeyes across the state and around the world make a lasting impact.
The Ohio State University sets the stage for academic achievement and innovation. It's where friendships are forged, tradition is brought to life and a better global community is built. Our mission is as clear today as it was 150 years ago: to illuminate a pathway to education, research and health care that creates vibrant futures. Faculty and staff build the incomparable Buckeye spirit through collaboration, a strong sense of community and an unwavering commitment to excellence. Our strength comes from our ability to bring out the best in people and learn from Buckeyes of all backgrounds, passions and talents. Ohio State is a dynamic community where opportunity thrives and individuals transform themselves and their world. Positions are available in countless fields and specialties.
Ohio State is a top-20 public university, and its Ohio State Wexner Medical Center is one of America’s leading academic health centers. Eligible Ohio State employees receive comprehensive benefits packages, including medical, dental and vision insurance, tuition assistance for employees and their dependents, and state or alternative retirement options with competitive employer contributions. Become a Buckeye and contribute to an incredible legacy that serves to guide our future and shape a better tomorrow.
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Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application.
Job Title: Pharmacy Audit and Reconciliation Coordinator Department: Retail Rx | OSU Outpatient Pharmacy CCCT
Scope of Position The Revenue Integrity Specialist optimizes the payment cycle for retail and specialty pharmacy claims. This role ensures accurate workflow of pharmacy accounts, reviews payments for accuracy, aligns collections with contracts, and follows up with insurance companies. The specialist secures third-party payments, ensures compliance with payer contracts, and maintains accurate secondary billing processes and vendor data feeds. They advocate for efficient claim resolution, provide proactive follow-up, and identify trends to ensure process accuracy. Additionally, they contribute to scalable process improvements, respond to and defend audit requests from commercial health plans/payors, and ensure the accuracy and completeness of claims to retain reimbursement. Position Summary This position assist s with revenue cycle related activities . These activities include but are not limited to reconciling payer remittances including unapplied cash, claim exceptions and partial pay understanding , payer denials and impact on revenue cycle , proactively communicate with onsite pharmacy staff, finance staff and insurance companies to resolve payment discrepancies . Advanced knowledge of, or experience with state, federal and PBM (Pharmacy Benefit Management/commercial health plans/payors) accreditation rules and regulations regarding pharmacy benefit and medical benefit claims billing . Th is position requires strong knowledge of Microsoft Excel, Microsoft Teams and other computer related skills. Minimum Qualifications For Hire:
Bachelor’s in Business, healthcare or related field or equivalent combination of education and related experience or 3 years experience as a pharmacy technician. Must be registered technician with the State of Ohio Board of Pharmacy and hold active PTCB/NHA certification prior to start date. On going:
PTCB certification and Board of Pharmacy registration as a Certified pharmacy technician must be maintained for continued employment. Additional Information:
Location: Ackerman Rd, 660 (0242) Position Type: Regular Scheduled Hours: 40
Shift:
Varying Shifts
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process. Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions . The university is an equal opportunity employer, including veterans and disability.
About Us
Each day, Buckeyes across the state and around the world make a lasting impact.
The Ohio State University sets the stage for academic achievement and innovation. It's where friendships are forged, tradition is brought to life and a better global community is built. Our mission is as clear today as it was 150 years ago: to illuminate a pathway to education, research and health care that creates vibrant futures. Faculty and staff build the incomparable Buckeye spirit through collaboration, a strong sense of community and an unwavering commitment to excellence. Our strength comes from our ability to bring out the best in people and learn from Buckeyes of all backgrounds, passions and talents. Ohio State is a dynamic community where opportunity thrives and individuals transform themselves and their world. Positions are available in countless fields and specialties.
Ohio State is a top-20 public university, and its Ohio State Wexner Medical Center is one of America’s leading academic health centers. Eligible Ohio State employees receive comprehensive benefits packages, including medical, dental and vision insurance, tuition assistance for employees and their dependents, and state or alternative retirement options with competitive employer contributions. Become a Buckeye and contribute to an incredible legacy that serves to guide our future and shape a better tomorrow.
#J-18808-Ljbffr