Allied Technician - Pharmacy Tech

Adventist Health; Roseville (CA); On-site; USD 105,000 - 113,000; Full time

Job summary

Adventist Health in Roseville, CA seeks a Pharmacy Billing Compliance Specialist to ensure accurate charging, billing, and reimbursement across outpatient hospital departments, compliant with CMS, HRSA, and payer guidelines.

Responsibilities include reviewing charges, validating NDC to HCPCS mappings, ensuring 340B and WAC policies, auditing, and correcting charge capture before submission.

Qualifications

• High School Education/GED or equivalent; Associate's/Technical Degree or relevant experience preferred.
• Minimum of three years' experience in pharmacy, revenue integrity, billing, or compliance is required.
• Experience with EMR/billing systems (Epic Resolute, Cerner) preferred.
• Current State Pharmacy Technician license is required (CA, OR, &/or HI).
• Pharmaceutical Technician Board certification preferred.
• Advanced certification such as CHRI, CRCR, or 340B ACE preferred.

Responsibilities

• Review and reconcile medication charges in outpatient hospital encounters.
• Validate NDC to HCPCS mapping, billable units, and modifiers per CMS and payer rules.
• Ensure compliance with 340B, GPO, and WAC pricing; collaborate with 340B teams.
• Participate in CMS, HRSA, and payer audits.
• Identify and correct charge capture errors prior to billing.
• Monitor UB-04 claim accuracy for outpatient medication billing.

Skills

Attention to detail

Compliance

Audit knowledge

Education

Associate's/Technical Degree or relevant experience

Tools

Epic Resolute

Cerner Revenue Cycle

Job description

Details

Client Name
Adventist Health

Job Type
Travel

Offering
Allied

Profession
Allied Technician

Specialty
Pharmacy Tech

Job ID
38400411

Weekly Pay
$2101.54

Shift Details

Shift
5X8 Days

Scheduled Hours
40

Job Order Details

Start Date
10/26/2026

End Date
01/25/2027

Duration
13 Week(s)

Job Description

Pharmacy Billing Compliance Specialist

We are seeking a dedicated and detail-oriented Pharmacy Billing Compliance Specialist to support accurate and compliant medication charging, billing, and reimbursement across various outpatient hospital departments. This role is essential in ensuring medication-related charges are complete, accurate, compliant, and aligned with regulations from the Centers for Medicare and Medicaid Services (CMS), health resources & services administration (HRSA), and payer guidelines.

Key Responsibilities:

• Review and reconcile medication charges in outpatient hospital encounters, including observation, infusion, surgery, and emergency departments.
• Validate National Drug Code (NDC) to Healthcare Common Procedure Coding System (HCPCS) mapping, billable units, and appropriate modifiers in accordance with CMS and payer requirements.
• Ensure compliance with 340B, Group Purchasing Organization (GPO), and Wholesale Acquisition Cost (WAC) pricing policies, collaborating with 340B Program Integrity teams to maintain audit readiness.
• Participate in internal and external audits, including those conducted by CMS, HRSA, and payer audits.
• Identify and correct charge capture errors prior to billing to ensure the submission of clean claims.
• Monitor UB-04 claim accuracy for outpatient medication billing, ensuring HCPCS and revenue codes align with clinical documentation.
• Collaborate with revenue integrity, Health Information Management (HIM), and pharmacy teams to maintain compliant and optimized Charge Description Master (CDM) and Medication Record Master File (ERX) entries.
• Stay updated on CMS outpatient prospective payment system (OPPS) modifications, HRSA guidance, NDC-to-HCPCS quarterly crosswalks, and specific payer requirements.
• Support the resolution of claim denials related to outpatient drug charges and associated modifiers.

Qualifications:

• High School Education/GED or equivalent; Associate's/Technical Degree or relevant experience preferred.
• Minimum of three years' experience in pharmacy, revenue integrity, billing, or compliance is required.
• Experience with Epic Resolute, Cerner Revenue Cycle, or similar EMR/billing systems is preferred.
• Current State Pharmacy Technician license is required (CA, OR, &/or HI).
• Pharmaceutical Technician Board certification is preferred.
• Advanced certification such as CHRI, CRCR, or 340B ACE is also preferred.

Client Details

Address
1 Adventist Health Way

City
Roseville

State
CA

Zip Code
95661