Accede Solutions Inc
Travel Technician in Philadelphia, PA
Accede Solutions Inc, Philadelphia, Pennsylvania, 19019
Pharmacy Technician Duration: 13 Weeks Start: 10/18/2024 Shift: 8:00 AM - 5:00 PM 100% Onsite Local Candidates Only The Ambulatory Regulatory Technician is responsible for helping to manage the internal and external pharmacy payer audits and requirements in accordance with Federal, State and Internal auditing standards. The Ambulatory Regulatory Technician will assist in the day-to-day activity of the outpatient pharmacy locations insurance audit requests, as well as proactive audits and regulatory compliance. The Ambulatory Regulatory Technician services more than 6 retail pharmacy locations in both Philadelphia and suburban locations. In addition to data compilation for fax or electronic audit, the auditing technician will support the managers during in person audits, proactively audit claims for accuracy and support needed regulatory requirements. The purpose of the Ambulatory Regulatory Technician is to help drive overall fiscal and regulatory performance and manage the daily activities of the insurance payer programs. Responsibilities: Key responsibilities will include ensuring timeliness of payer audit completion, ensuring accuracy of information submitted, assessing the risks in the pharmacy audit assignment, perform appropriate audit procedures, draft and communicate audit findings and observations and collaborate with pharmacy management to resolve issues in a timely and efficient manner. • Conducts desktop and onsite audits for the HUP Pharmacies and in accordance with Federal, State, and Internal Audit standards • Proactive claims auditing to ensure the appropriateness and accuracy of submitted pharmacy claims • Handling third-party requests in coordination with the Pharmacy Managers • Auditing delivery processes to ensure medications are delivered and receipts are on record • Within the general guidelines provided by management, will conduct the following tasks: assess the risks in the pharmacy audit assignment, perform appropriate audit procedures, draft and communicate audit findings and observations, and collaborate with pharmacy management to resolve issues in a timely and efficient manner • Assists with ongoing regulatory compliance and accreditation surveys and monitors compliance with billing practices and collection of copays Leads meetings in conjunction with management and performs quality assurance checks of pharmacy payer documentation to ensure accuracy and completeness. • Completion of payer regulatory requirements • Performs duties in accordance with and entity values, policies, and procedures • Other duties as assigned to support the unit, department, entity, and health system organization Requirements: CPHT REQUIRED Accede: Accede Solutions is a Nationally Certified Search firm providing services in multiple sectors. We are a Women and Minority-owned Business with a strong emphasis on Diversity, Equity, and Inclusion (DEI). We have managed and Implemented Talent Acquisition and Talent Management processes and had successful engagement with clients in the areas of Financial Services, Technology, healthcare and professional services. We provide a full range of talent acquisition and management services designed to maximize the efficiency of your information management operation. From executive recruiting, to contract-to-hire placement, to contract employment, we offer solutions for your day-to-day workflow issues as well as workload spikes and special projects. We also specialize in retained executive search focused on recruiting distinctive leaders and C level roles. With a track record of successfully recruiting key human capital leaders, we have earned a reputation for insightful and nuanced cultural advisory work built on a platform of strong capability supported by a rigorous and artful approach in assessing cultural fit. We were listed as Fast 100 Asian American firm in 2023 & 2024 by USPAACC and listed as 2115 fastest growing companies in US in INC5000 Equal Opportunity Employer: Females/Minorities/Veterans/Individuals with Disabilities Accede is committed to equal employment opportunity to all employees and applicants without regard to race, religion, color, gender identity, ethnicity, age, national origin, sexual orientation, disability status, veteran status or any other category protected by applicable law. IND123