Pharmacy Reimbursement Specialist

at MaineHealth in Westbrook, Maine, United States

Job Description

Summary

After a successful in house training period, this is a Hybrid position
Position Summary
Evaluates billing and reimbursement of medications provided to patients. Works with multidisciplinary groups to develop proper procedures and programs to maximize reimbursement. Facilitates process and system improvements to maintain compliance with insurer requirements and reduce the likelihood of occurrence of loss of reimbursement relating to pharmaceuticals.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
Education: N/A
License/Certifications:An RHIT/RHIA/CCS certification from the American Health Information Management Association or clinical experience as a pharmacist, pharmacy technician, or pharmacy revenue specialist is preferred.
Experience:See "License/Certifications"
Maintains the necessary and appropriate level of continuing education to support job responsibilities.
A broad knowledge of medical terminology, anatomy, physiology, patho-physiology, and disease processes.
Ability to work and interact with several departments to achieve maximum compliance.
Effective verbal and written communication skills.
Ability to manage and lead multiple projects.
Strong analytical and problem-solving skills are essential attributes for this position.
Ability to work independently and is self-directed.

Additional Information

MaineHealth was ranked one of America's Best Large Employers in 2022 by Forbes!

MaineHealth is a not-for-profit integrated health system whose vision is, "Working together so our communities are the healthiest in America." MaineHealth consists of nine local health systems, a comprehensive behavioral health care network, diagnostic services, home health agencies, and 1,700 employed clinicians working together through the MaineHealth Medical Group. With approximately 22,000 care team members, MaineHealth provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire. Learn more about our system at

At MaineHealth, we offer benefits that support an individual's needs for today and flexibility to plan for tomorrow. Our packages include health and dental insurances, paid parental leave, retirement program, generous paid time off, and much more! Our comprehensive array of benefits are competitive, affordable, and include choices that meet specific, but ever changing, needs.

With a career at any of the MaineHealth locations, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the neighborhoods that surround it. We are deeply invested in the well-being of our communities and care team members. We believe in fostering a work environment of strong commitment, compassionate caring and continuous improvement. Join us, and your abilities will be challenged and enhanced as you take your career to a new level.
Additional Information  MaineHealth is a health system whose members and affiliates include hospitals, physician practices, long-term care facilities, home care agencies, and support services. Learn more about this system at www.mainehealth.org

MaineHealth values diversity and is an Equal Opportunity/Affirmative Action employer. Federal and state laws prohibit discrimination in employment because of race, color, national origin, religion, age, sex, sexual orientation, disability or veteran status.