Job Description

The Pharmacy Operations Specialist works with retail pharmacy business units and their respective leaders to develop and implement successful workflows for outpatient retail pharmacy professional billing and reconciliations. The Pharmacy Operations Specialist will collaborate with HealthPartners finance, pharmacy leaders, patients, and external vendors to ensure charges and sales are correctly billed, invoiced, and paid. In addition, the Pharmacy Operations Specialist will support pharmacy operations in responding to external and internal third party, regulatory, and compliance audits. Role may include traveling to other HealthPartners Pharmacies and its affiliates as needed.

Essential Duties:

• Manage various professional billing work queues for all HealthPartners retail pharmacies.
• Review patient pharmacy accounts to ensure that charges and payments are accurate and obtains necessary information and records to research and resolve account errors.
• Communicate with insurance companies on behalf or patients to process claims and help resolve billing issues.
• Provide feedback to pharmacy team of incorrect or inaccurate processing of claims or financial transactions of procedures.
• Coordinate the write-off of uncollected or uncollectible pharmacy claims.
• Verify, audit, and reconcile claims and payments in the system for all HealthPartners retail pharmacies.
• Responsible for the coordination and maintenance of non-adjusted third-party plans and third-party reconciliation software
• Analyze accounts receivable balances and revenue variations.
• Travel to other HealthPartners Pharmacies and its affiliates to conduct audits when appropriate and/or required.
• Develop and maintain audit tools, assist in defining reports and present summaries to key stakeholders, including recommendations for corrective action and follow up.
• Communicate with patients to address patient questions/concerns regarding patient statements.
• Maintain appropriate confidentiality of information in accordance with policies.
• Work directly with pharmacy system vendors and/or pharmacy leader on problem identification and resolution.

MINIMUM QUALIFICATIONS:

• Minimum of three years pharmacy operations experience as a Pharmacy Technician, pharmacy purchasing and inventory management in a retail pharmacy setting
• Experience with analyzing and reporting data to identify issues, trends, or expectations to drive improvement of results and find solutions
• Certified Pharmacy technician or equivalent program certificate
• Certification through the Pharmacy Technician Certification Board (PTCB)

PREFERRED QUALIFICATIONS:

• Undergraduate Degree preferred or related experience.
• Experience with Epic Willow Ambulatory and Epic Professional Billing preferred
  
  

Benefits:

At Hudson Hospital & Clinic, we offer competitive wages and an excellent benefits package (0.5 FTE or greater) that includes:

• Health, vision and dental insurance

• 401k retirement program

• Competitive paid time off (PTO)

• Short-term disability pay, long-term disability and life insurance options

• Flexible spending accounts (FSAs)

• Education reimbursement

• Employee assistance programs (EAP), an employee well-being program

• Free parking

• Employee recognition and rewards.

About Hudson Hospital & Clinic:

Hudson Hospital & Clinic is part of HealthPartners, a comprehensive health care system serving more than 1.2 million patients across Minnesota and western Wisconsin. Hudson Hospital & Clinic has been a trusted caretaker of the Hudson, Wisconsin community for 70 years, working closely with our partner hospitals and clinics in the St. Croix Valley. Our team includes around 415 employees, more than 70+ providers, and 38 volunteers, offering a full range of hospital, primary, and specialty care services.

We are an award-winning hospital, located just off I-94 between the Minnesota and Wisconsin border, where you’ll find exceptional, personalized care at Hudson Hospital & Clinic. Join us and become a partner for good, helping to improve the health and wellbeing of our patients, members, and the community we serve.

At HealthPartners we believe in the power of good – good deeds and good people working together. As part of our team, you’ll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.

We’re a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.

At HealthPartners, everyone is welcome, included and valued. We’re working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.

Benefits Designed to Support Your Total Health
As a HealthPartners colleague, we’re committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal is to help you thrive physically, mentally, emotionally, and financially, so you can continue delivering exceptional care.

Join us in our mission to improve the health and well-being of our patients, members, and communities.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class.