Flexible Pharmacy Staffing has an immediate opening for a Pharmacy Credentialing Agency Compliance Specialist for a Specialty Pharmacy Client located in Louisville, Kentucky.
– Monday – Friday 8:00 AM- 5:00 PM
Possible duties may include:
• Assist in completion and compilation of all documents and paperwork necessary for PBM contracting projects, specifically movement from PSAO group contracting to Direct Payer contracts.
• Serve as the primary resource of facility ownership, name and address information for countless purposes throughout the company. Communicate pharmacy changes/closing/openings throughout the company to maintain consistent and accurate facility information.
• Maintain documented licensure for each facility with BOP, DEA and where required, State CSR licensing agency.
• NCPDP enrollment and updates.
• NPI enrollment and updates with NPPES.
• Medicare and Medicaid enrollment and updates, including the establishment of Electronic Funds Transfer (EFT) and Electronic Data Interchange (EDI) allowing claims to be submitted & R/As retrieved electronically), participation problem research and resolution as well as communication of new enrollments to Reimbursement and Operations teams.
• Provide operating data (# of facilities, states operated/licensed, states of participation in Medicaid, etc.) for reporting purposes, including Quarterly & Annual Financial reports.
• Execute such other functions as delegated by the Reimbursement Director or Supervisor.
• All other duties as assigned.
• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
• Associates Degree in Accounting, Healthcare Administration, Business or Law.
• At least one (1) year of pharmacy licensure experience, as well as Medicare and Medicaid enrollment experience as a healthcare provider.
• Knowledge of State Boards of Pharmacy licensure requirements, Medicare and state Medicaid enrollment process. Familiarity with NCPDP & NPPES organizations and enrollment processes. Superior analytical, oral and written communication, problem-solving, organizational and planning skills. Proficient in Microsoft Office software, including Excel, Outlook, and Word.
• 3-5 years PBM or credentialing experience
• Experience of legal terminology as related to the healthcare industry.
• Driven, energetic individual with experience of operating within the professional standards of a large pharmaceutical company.
**PLEASE ATTACH RESUME IF POSSIBLE (or email to us after you submit and receive submission acknowledgment)**