Inside Higher Ed · 2 weeks ago
Senior Pharmacy Audit and Reconciliation Coordinator
Columbus, OH
Full-time
Onsite
Mid, Senior Level
3+ years expThe Ohio State University is seeking a Senior Pharmacy Audit and Reconciliation Coordinator to provide expert knowledge in Medicare billing and audit requirements for pharmacy-dispensed products. This role involves overseeing audit management and compliance for retail and specialty pharmacy claims, requiring strong analytical and communication skills to support pharmacy operations effectively.
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Responsibilities
Oversees Medicare and pharmacy benefit manager audit management and response
Audit and compliance for retail and specialty pharmacy claims billed to Medicare, Medicaid, and pharmacy benefit managers
Requires an expert understanding of regulatory knowledge related to billing and payment of retail, specialty, and Medicare pharmacy claims
Oversight of all audits of retail and specialty prescription claims
Management of the OSU OP revenue cycle, including the escalation of complex claims and unpaid or denied claims
Qualification
Required
Bachelor's in Business, healthcare or related field or equivalent combination of education and related experience
3 years of experience as a Pharmacy Audit and Reconciliation Coordinator (S2) or similar position at another Health System
Must be registered technician with the State of Ohio Board of Pharmacy
Hold active PTCB/NHA certification
Preferred
4 to 8 years of relevant experience
Company
Inside Higher Ed
Inside Higher Ed is the online source for news, opinion, and jobs related to higher education.
51-200 employees
Funding
Current Stage
Growth StageTotal Funding
unknown2022-01-10Acquired
2006-08-31Series Unknown
Leadership Team
Stephanie Shweiki
Director, Foundation Partnerships
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