Pharmacy Audit and Reconciliation Coordinator

Ohio State University; Columbus (OH); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off + holidays

State retirement plan

Job summary

The Ohio State University Outpatient Pharmacy is seeking a Pharmacy Audit and Reconciliation Coordinator to optimize the payment cycle for retail and specialty pharmacy claims. You will ensure accurate workflow of pharmacy accounts, review payments for accuracy, and align collections with contracts across eight OSU Outpatient Pharmacy sites.

This role requires a Bachelor's degree or equivalent, a Certified Pharmacy Technician credential, and 2 years of relevant experience.

Qualifications

• Bachelor's Degree or equivalent combination of education and experience.
• Certified Pharmacy Technician.
• 2 years of relevant experience required.
• 2-4 years of relevant experience preferred.

Responsibilities

• The Revenue Integrity Specialist optimizes the payment cycle for retail and specialty pharmacy claims.
• Reviews payments for accuracy, aligns collections with contracts, and follows up with insurance companies.
• Secures third-party payments, ensures compliance with payer contracts, and maintains accurate secondary billing processes.
• Responds to audit requests and defends reimbursement challenges for all OSU Outpatient Pharmacy sites.

Skills

Certified Pharmacy Technician

2+ years of relevant experience

Experience with pharmacy claims

Education

Bachelor's Degree or equivalent combination of education and experience

Job description

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Job Title: Pharmacy Audit and Reconciliation Coordinator

Department: Retail Rx | OSU Outpatient Pharmacy

Scope of Position

The Revenue Integrity Specialist optimizes the payment cycle for retail and specialty pharmacy claims. This role ensures accurate workflow of pharmacy accounts, reviews payments for accuracy, aligns collections with contracts, and follows up with insurance companies. The specialist secures third-party payments, ensures compliance with payer contracts, and maintains accurate secondary billing processes and vendor data feeds. They advocate for efficient claim resolution, provide proactive follow-up, and identify trends to ensure process accuracy. Additionally, they contribute to scalable process improvements, respond to and defend audit requests from commercial health plans/payors, and ensure the accuracy and completeness of claims to retain reimbursement.

Position Summary

The Ohio State University (OSU) Outpatient Pharmacy’s mission is to improve people’s lives through pharmacy practice innovation, comprehensive medication education, and collaborative clinical and practice research. The OSU Outpatient Pharmacy generates more $250M in annual revenue and processes more than250,000claims at 8 pharmacy locations. This position will provide claims reconciliation, claims filing, audit support and response and reimbursement challenges for all 8 OSU Outpatient Pharmacy sites.

Minimum Qualifications

Bachelor's Degree or equivalent combination of education and experience. Certified Pharmacy Technician. 2 years of relevant experience required. 2-4 years of relevant experience preferred.

Additional Information

Location: Ackerman Rd, 660 (0242) Position Type: Regular Scheduled Hours: 40 Shift: Varying Shifts Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.

Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions. The university is an equal opportunity employer, including veterans and disability. At Ohio State, you’ll find work that inspires you. We offer roles and growth opportunities in countless fields and specialties - including a job that’s right for you. Ohio State benefits give you options to take care of what matters most to you - and opportunities to make adjustments as your life and needs change, including:

• Medical, dental and vision coverage, with Ohio State paying a significant portion of the cost.
• Paid time off, including sick and vacation time and 11 holidays.
• State retirement plan or an alternative retirement plan, both with generous employer contributions.

As Buckeyes, we accomplish more together. No matter your role, you’ll be part of creating what people need now: pathways to education, research and health care. Working at Ohio State means you’re part of a team with a strong sense of community and an unwavering commitment to excellence - and, of course, incomparable Buckeye spirit. We bring out the best in people, help each other succeed and learn together. By joining Ohio State, you become part of a top-20 public university with one of America’s leading academic health centers. We’re a team of dedicated colleagues with access to boundless resources that support you. Review the Frequently Asked Questions for details on using Workday and submitting your application.