Supervisor, Third Party Operations:
PharMerica

38500-en_US
PharMerica
Taunton Sout
Pharmacy
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Description

A full-service pharmacy solution providing value beyond medication.

PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. With over $3 billion annual revenues, PharMerica is one of the nation's largest pharmacy companiesPharMerica operates more than 105 institutional pharmacies in 47 states serving over 350,000+ patients daily.

 

PharMerica offers unmatched employee development. Exceptional company culture. Seemingly endless opportunities for advancement and the highest hiring goals in decades.

 

 

Summary

Supervises 3rd Party Claims Processing staff on a daily basis to resolve and monitor at risk revenue and ensuring achievement of company and departmental goals.

 

Major Responsibilities:

•             Primary role of Supervisor is to manage work flow and productivity of Associate 1 and Associate 2 staff. 

•             Provides associates assignments and work queues on a daily and/or weekly basis.  Including:

o             Denial/internal error resolution

o             Convert exception resolution

o             Back up Pharmacy billing

o             IV billing

o             Manual claim billing

o             Insure  work is evenly distributed based on associates knowledge and skill set

•             Monitors quality of work performed by associates – which includes: 

o             Internal and External Interactions (verbal and electronic)

o             Denial management and claim resolution compliance

•             Report to Manager any trends occurring with payers and/or processes

•             Provides coaching and mentoring to associates to ensure work quality and skill needs are met.

•             Updates staff with communications and process changes as directed by 3rd Party Claims Manager, Director or Senior Management and insures compliance.

•             Works in conjunction with the 3rd Party Claims Manager to establish specific associate goals, department wide goals, performance tracking and quality assessment audits.

•             Handles escalated calls from customers and payors to ensure proper resolution.

•             Mentor and provide oversight of Associate II staff to insure they are adequately communicating staff training needs, shadowing staff when assigned, performing monthly quality assessment reviews, and taking a lead role in any special projects that may be assigned by Supervisor or Manager.

•             Manages staff attendance and time sheets for payroll (Day Force) system.  Assures staff is meeting attendance policies and reports any variations to Manager.

•             Ensures SOX compliance on all variance and write-off (bad debt) and convert exception reports inclusive adequate signatures are obtained.

        Proper storage of completed documents per Compliance policies.

 

Position Qualifications

•             Education/Learning Experience

             Required: Associates degree

             Desired: 4 year college or technical degree

•             Work Experience 

               Desired: Third Party Billing or collections/billing experience in the healthcare industry

                       AS-400 computer experience, Pharmacy Technician.

•             Skills/Knowledge

             Required: Microsoft Suite Package Experience (Basic Level)

             Desired: AS400 Computer Systems Experience, typing skills and Excel Spreadsheet experience

•             Licenses/Certifications 

             Required:  N/A

             Desired:  N/A

•             Behavior Competencies

             Required: Communication, Problem Solving, Detail Oriented and Teamwork, Customer Service, and Accuracy.

             Desired: Strong attendance, organization skills, self-starter, and confidence

 

EOE M/F/D/V

Accelerate Your Career with PharMerica!

Basic Qualifications
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