Penn State Health Corporation
Work Type: Full Time
Hours: 8:00a - 5:00p
SUMMARY OF POSITION:
Working under general supervision, this position is responsible for project leadership and ongoing information technology management for one or more small-to-medium sized operational area within the Medical Center. This position must lead project teams of IRT personnel and other department personnel in planning and executing projects in operational areas. This position is remote, but may require on-site responsibilities throughout the year.
PHARMACY CHARGE, BILLING, AND CODING:
Primary consultant for PSH in relation to pharmacy charges and billing
Ensure charge and billing compliance
NDC maintenance for clinic locations (required for BCMA)
Primary NDC audit vs purchase history for hospitals (and clinics)
Validation of new product HCPCS, revenue codes, and modifiers (JW, JG, TB, PO, PN)
HCPCS QCF validation (dose to unit calculations
CMS changes (review quarterly updates and advise changes)
Periodic validation of formulary build (HCPCS, modifiers, rev codes)
Cost updates and variation audits (with notification of PFS)
Price schedule flexing and maintenance
DAILY CHARGE ACTIVITIES:
Reconciling clinic charges due to unverified orders
Assist with clinic pending charges
Injectables as orals (e.g. dexamethasone) - rebill without HCPCS code
Anesthesia charge auditing
Denial of insurance payments on high dollar medications
Reconciliation of Promise billing
Blood Factor auditing
Other high dollar medications
Clinic charges - procedure to med charge reconciliation
Either: (a) Bachelor's degree plus four additional years of related experience or (b) eight years total of related experience required.
In-depth knowledge of at least one area of information technology and a solid working knowledge of several areas of information technology required.
Proficiency in the use of Microsoft Office required.
Adheres to and exhibits our organizational core values as outlined by Penn State Health.
If chosen for this position, you may required to pass a Post Offer Employment Physical Exam in accordance with the measurements listed in the Work Task Analysis (WTA) report. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.
Penn State Health is fundamentally committed to the diversity of our faculty and staff. We believe diversity is unapologetically expressing itself through every person's perspectives and lived experiences. We are an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, martial status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information. If you are unable to use our online application process due to an impairment or disability, please call 717-531-8440 between the hours of 7:30 AM and 4:30 PM, Eastern Standard Time, Monday through Friday, email firstname.lastname@example.org or download our Accommodation Instructions for Job Applicants PDF for more detailed steps for assistance.