Inpatient Pharmacy Technician at Cambia Health Solutions, Inc

Inpatient Pharmacy Technician

Work from home within Oregon, Washington, Idaho, Utah. Candidates outside of these 4 states will not be considered.

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Who We Are Looking For:

Every day, Cambia's dedicated team of Inpatient Pharmacy Technicians are living our mission to make health care easier and lives better. As a member of the Healthcare Analytics team, our Inpatient Pharmacy Technician utilizes knowledge of drugs and pharmaceuticals to conduct post service audits to ensure accuracy of billed charges - all in service of creating an economically sustainable healthcare system.

Do you thrive as a part of a collaborate, caring team? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

An Inpatient Pharmacy Technician would have a license/certification as a Pharmacy Technician or Licensed Practical Nurse and 2 years of experience in hospital or residential treatment facility and 3 years of health insurance claims experience or analytical experience or equivalent combination of education and experience. Payment review or coding experience is a plus.

Required Licenses, Certifications, Registration, Etc.:

Licensed Practical Nurse (LPN), or Licensed Pharmacy Technician

Skills and Attributes:

• Demonstrated competency in claim review and experience using billing and claims forms.

• In-depth knowledge of drugs and pharmaceuticals to identify incorrectly billed medications, IV fluids and identify use of drugs for non-FDA approved treatments for investigational and off-label uses/administration.

• Familiarity with health care documentation and effective oral and written communication skills.

• Demonstrated initiative and strong problem-solving skills.

• Demonstrated ability to consistently meet productivity and quality standards with minimal support.

• Ability to work in fast-paced, multi-tasking, fluid environment with ever-changing priorities.

• General computer skills (Microsoft Office, Outlook, Internet search).

What You Will Do at Cambia:

• Prioritizes work, sets goals, and coordinates own activities to ensure that record reviews are performed so that timely audits can be performed according to the team's workflow.

• Utilizes knowledge and experience to analyze billings to determine if charges are consistent with medical records, medical for drugs/pharmaceuticals and reimbursement policies. Identifies additional information needed and requests it when appropriate. May perform activities that require evaluation or interpretation of information related to drug administration and treatments.

• Follows strict guidelines to ensure all work meets corporate standards for accuracy, timeliness, quality and compliance with federal, state, BCBSA and accreditation regulations. Organizes and keeps readily accessible all reference documents, policies and procedures needed to accomplish this.

• Follows through on all assigned work; performs at a level meeting production requirements and quality standards.

• Contributes to the efficiency of the department by being flexible and cross-trained on other functions.

• Performs projects as requested by the supervisor.

Work Environment:

• Work primarily performed in office environment.

• Travel may be required locally or out of state.

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