340B PHARMACY BILLING ANALYST

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values—integrity, patient-centered, respect, accountability, and compassion—must guide what we do, as individuals and professionals, every day.

Under the direction of the 340B Program Integrity Manager, the 340B Program Billing Analyst is responsible for
assisting with auditing the functions and tasks related to the pharmaceutical billing /revenue cycle and 340B
program for YNHHS. This includes identification and qualification of billable events eligible for 340B program.

EEO/AA/Disability/Veteran

Responsibilities

  • 1. 340B Compliance and Auditing
    Assists in the monitoring and various tracking and reporting measurements to ensure compliance with the
    program. Reviews reports on billing, reimbursement, revenue cycle and 340B eligibility that clearly
    document utilization, savings, problem areas, exceptions, and/or discrepancies to pharmacy and
    administrative leadership. Communicates to specialist and/or manager key metrics and improvement
    actions to management. Ensures appropriate documentation and audit trail across areas of responsibility
  • 2. Information Systems: Monitor and assist with issue resolution of all Craneware Application and /or any other
    related CMS, CDM findings. Assist with integration information from the pharmacy chargemaster system
    into the 340B split-billing computer system. Monitors and assist with issue resolution with EPIC and all
    associated Billing system to ensure charge capture and revenue cycle optimization.
  • 3. Education: Assist in development and dissemination of billing, reimbursement and revenue cycle and
    340B quality assurance training for employees as appropriate. Assist in providing proactive education to
    staff on policies and procedures billing management and 340B procedures. Expand professional
    development through related classes and seminars, current publications, and regional /national association
    membership participation Certified Coding Associate (CCA), Certified Professional Coder (CPC).
  • 4. Leadership: Strive to consistently improve the overall efficiency, value, and internal support billing
    compliance and the 340B program. Facilitate productive exchanges of information to improve program
    efficiency and promote program compliance. Provide data, information, and reports as needed to ensure
    appropriate escalation to pharmacy and corporate leadership
  • 5. Participates in departmental, organizational and/or health system committees related to pharmacy services
    ,
    medication procurement, finance and other hospital initiatives as appropriate

Qualifications

EDUCATION


Requires broad training in fields such as pharmacy technician, medical coding , compliance/auditing or similar
vocations generally obtained through completion of associate 's degree program. Medical Coding experience or
certification is highly desirable


EXPERIENCE


5-10 years experieince as a pharmacy technician, medical coding or related health care experience. Two years
experience in overseeing project or demonstrable administrative/leadership tasks


LICENSURE


5-10 years experieince as a pharmacy technician, medical coding or related health care experience. Two years
experience in overseeing project or demonstrable administrative/leadership tasks


SPECIAL SKILLS


Must have excellent communication skills and the ability to prioritize and multitask /change tasks frequently and
quickly. Knowledge of drug products preferred. Knowledge of requirements for medical coding is recommended .
Must be competent with Microsoft Office applications, including Excel and Access.



See Inside the Office of Yale New Haven Hospital

Yale New Haven Hospital provides diverse comprehensive care in over 100 medical specialties. As the primary teaching hospital of the Yale School of Medicine, YNHH provides around-the-clock coverage and insightful, research-supported patient care. In addition to providing quality medical care to patients and families, Yale New Haven Hospital is the second largest employer in the New Haven area, with more than 12,000 employees.


Back to top