Pharmacy Tech Revenue and Audit Specialist

FROEDTERT HEALTH; Menomonee Falls (WI); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Paid time off

Growth opportunity- Career Pathways & 

Career Tuition Assistance

CEU opportunities

Academic Partnership with the Medical 

College of Wisconsin

Referral bonuses

Retirement plan - 403b

Medical, Dental, Vision, LifeInsurance

Short & Long Term Disability

Free Workplace Clinics

Employee Assistance Programs

Adoption Assistance

Healthy Contributions

Care@Work

Moving Assistance

Discounts on gym memberships

Job summary

The Revenue & Audit Specialist at Froedtert Health in Menomonee Falls supports accurate billing, reimbursement, and compliance for pharmacy claims. This role acts as a liaison among patients, pharmacies, insurers, and other parties to ensure timely, accurate processing and profitable operations under applicable Wisconsin regulations.

You will perform internal audits of retail pharmacy practices and handle external audit functions, working within the Wisconsin Pharmacy Examining Board guidelines

Qualifications

• A minimum of 5 years of experience as a pharmacy technician is required.
• Experience with third party insurances including Medicare and Medicaid is required.
• A minimum of 7 years of senior level pharmacy experience is preferred.
• High School Diploma or GED is required; Bachelor's degree preferred.
• Wisconsin registration must be obtained by hire date & certification (CPhT or ExCPT) within 6 months of hire.

Responsibilities

• Ensure accurate billing, reimbursement, and compliance for pharmacy claims.
• Serve as liaison between patient, pharmacy, insurer, and other parties to support customer service and profitability.
• Conduct timely internal audits of retail pharmacy practices and handle external audit functions.
• Work within Wisconsin regulatory guidelines (Wisconsin Statutes and Pharmacy Examining Board) and perform other duties as assigned.

Skills

Attention to detail

Organizational skills

Follow-up skills

EOB analysis

Analytical

Education

High School Diploma or GED

Bachelor's degree

Tools

Word processing

Spreadsheets

Presentation software

Job description

Discover. Achieve. Succeed. #BeHere

Location: US:WI:MENOMONEE FALLS at our CP-NORTH HILLS HEALTH CENTER facility.

This job is HYBRID.

FTE: 1.000000

Standard Hours: 40.00

Shift: 1

Shift Details:

Monday-Friday day shift, no holidays or weekends

Job Summary:

The Revenue & Audit Specialist is responsible for ensuring accurate billing, reimbursement, and compliance for pharmacy claims. The position will operate as a liaison between patient, pharmacy, insurance provider, and other involved third parties to drive excellent customer service and profitability to Froedtert Health. The position is responsible for timely internal auditing of retail pharmacy practice as well as handling all external audit functions. Operates within the guidelines of Chapter 7 of the Wisconsin Statutes and Administrative Code -Pharmacy Examining Board -Pharmacy Practice Sections. Other duties as assigned.

EXPERIENCE DESCRIPTION:

A minimum of 5 years of experience as a pharmacy technician is required. Experience with third party insurances including, but not limited to, Medicare and Medicaid is required. A minimum of 7 years of senior level pharmacy experience is preferred.

EDUCATION DESCRIPTION:

High School Diploma or GED equivalency is required. Bachelor's Degree is preferred.

SPECIAL SKILLS DESCRIPTION:

Proven attention to detail. Outstanding organizational and follow-up skills. Ability to analyze EOB (Explanation of Benefits) statements. Experience with various computer systems and programs, including word processing, spreadsheet, and presentation.

LICENSURE DESCRIPTION:

Application for Wisconsin registration as a Pharmacy Technician is required by hire date and must be obtained within 12 months of hire. Staff hired into this role prior to 3/31/23 must have applied for Wisconsin registration by 3/31/23 and have until 3/31/24 to obtain registration. Certification through Pharmacy Technician Certification Board (CPhT) or National Healthcare Association (ExCPT) is required within 6 months of hire.

Perks & Benefits at Froedtert Health

• Paid time off
• Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
• Academic Partnership with the Medical College of Wisconsin
• Referral bonuses
• Retirement plan - 403b
• Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
• Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available

The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.