Pharmacy Accounts Auditor - Hybrid

• Monday - Friday, no weekends or holidays
• 7:00 AM - 3:00 PM
• This is a hybrid role (onsite and work from home when appropriate for business needs.)

Plans and performs charge capture reviews in accordance with proper billing practices. Collaborates with internal and external customers on billing and coding functions to determine billing accuracy and optimize revenue capture. Develops written reports documenting review findings and recommendations.

• →Maintains a comprehensive and current level of knowledge of new developments and issues related to coding, charge capture, accounting, and billing compliance in the healthcare environment   

• →Serves as a resource for department managers, staff, and administration to obtain information on guidelines and regulatory standards of coding and billing 

• →Recommends new policies, procedures, and strategies to streamline workflows and ensure department is meeting organizational objectives and goals  

• →Documents and/or reviews all data collected during the review, identifying all billing, coding, and documentation errors 

• →Reviews HCPCS and coding updates, as applicable 

• →Reviews clinical documentation to ensure accurate CPT/HCPCS code assignment and appropriate reimbursement 

• →Utilizes findings to develop and coordinate educational and training programs for specific functional areas for departmental staff  

• →Verifies the validity of data/reports used and generated and adheres to system policies and procedures 

• →Follows through to ensure that any critical corrective action is taken and evaluates efficiency of interventions  

• →Prepares management reports, spreadsheets, and executive summaries of review findings 

• →Plans scope of review and communicates plan with leadership 

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

• Pharmacy Technician registration with Georgia state board of pharmacy per state of employment requirements.
• PTCB or ExCPT certification.  

• Typically two years’ experience with or exposure to relevant billing systems i.e. EPIC/Encompass. 
• Auditing and purchasing experience.

• Highly effective communication (written and verbal) and interpersonal skills 

• Exceptional customer service, problem resolution and process development skills 

• Demonstrated leadership skills such as delegation, team building, managing multiple priorities, problem solving, and decision making 

• Ability to understand and become knowledgeable of pharmacy standards, policies, procedures, and Health Insurance Portability and Accountability Act (HIPAA) regulations  

• Demonstrated ability to maintain confidentiality, take imitative, and to work independently with minimal supervision 

• Must be detail-oriented with the ability to handle multiple demands simultaneously 

• Basic math skills 

• Strong background in medical terminology preferred 

• Organizational skills and analytical ability to prepare reports and reconcile reports correctly 

• Computer skills with Microsoft Office, email, internet access, electronic pharmacy management systems, and pharmacy ordering and inventory systems 

• Life support training courses may be required dependent on department discretion 

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.