Pharmacy Denial Specialist, System Infusion Pharmacy Hub, FT, 8A-4:30P

Identify and streamline the denials process in an effort to improve and optimize the recovery efforts and maximize productivity. Assist with the review of medical record documentation for the overturning of medication-related denials generated by insurance companies. Serves as a resource for Denials Management and other departments within BHSF to proactively avoid unnecessary appeals. Responsible for maintaining a file containing all pertinent information on denials and issues in order to communicate all issues to teammates and management. Work closely with a multidisciplinary team to evaluate and improve the denial management, documentation and appeals process. Engages in activities that produce an increase in cash collections for the department. Degrees:

• Associates.

Additional Qualifications:

• Prior experience in pharmacy, corporate operational setting or hospital business office preferred.
• RPT, CPhT, PTCB certification recommended.
• Experience using Soarian, JDA, Workstation Lists and Microsoft Excel.
• Wide range knowledge manipulating and compiling information using multiple systems.
• Analytical, critical thinking, detail oriented, problem solving, and interpersonal skills required.
• Ability to manage multiple tasks and have excellent organization skills while working under pressure in order to meet stringent deadlines.
• Initiative, attention to detail, follow-through skills and ability to work independently and within a team based department.
• Excellent time-management skills.
• Interpersonal skills, professional conduct and communication skills to effectively gather information, ask questions and discuss problems with internal personnel.

Minimum Required Experience: 5 Years