340B Auditor Technician at Memorial Healthcare – Owosso, Michigan

JOB SUMMARY

Under direct supervision of the Outpatient Pharmacy Operations Specialist & Outpatient Pharmacy Director collaborates with the inpatient 340B committee and outpatient pharmacies to manage claim rebilling, perform audits, maintain the PioneerRx dispensing software, and support compliance efforts, helping ensure the financial integrity and effectiveness of the 340B program. Strives for superior performance by consistently providing a product or service to leadership and staff that is recognized as ultimately contributing to the patient and family experience. Recognizes and demonstrates understanding of patient and family centered care.

PRIMARY JOB RESPONSIBILITIES

1. Conduct daily audits of outpatient pharmacy claims to ensure accurate billing and coding compliance for eligible and ineligible 340B claims using PharmaForce and PioneerRx
2. Rebill 340B claims for outpatient pharmacies to ensure proper reimbursement and compliance
3. Generate and analyze financial reports to monitor 340B program performance within outpatient pharmacy operations
4. Maintain and optimize PioneerRx dispensing software functionality to support accurate billing, coding, and 340B compliance
5. Stay current on 340B regulations, policy updates, and industry changes to ensure ongoing program compliance
6. Submit 340B rebates as part of the 340B Rebate Model Pilot Program for outpatient pharmacy claims
7. Complete insurance audits in regards to 340B reporting
8. Ensures compliance with regulatory requirements as it relates to 340B
9. Assists purchaser in optimization of inventory management with par level adjustments and maintains good working relationships with key stakeholders
10. Demonstrates knowledge of and supports hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, customer service standards, and the code of ethical behavior.

DEPARTMENTAL AND ADDITIONAL JOB RESPONSIBILITIES

1. Support daily outpatient pharmacy workflow operations to ensure efficiency and continuity of services
2. Other duties as assigned

JOB SPECIFICATIONS

EDUCATION:

1. Pharmacy technician state license
2. PCTB (preferred)
3. 340B Certified (Preferred)
4. High School Diploma or GED equivalent (Required)

EXPERIENCE:

1. Microsoft Excel & Word (Preferred)
2. PioneerRx Pharmacy Dispensing Software (Preferred)
3. Pharmaforce Software/Reporting Navigation (Preferred)
4. Outpatient Pharmacy Operations (Preferred)
5. IT Competent/Proficient (Required)

ESSENTIAL PHYSICAL ABILITIES/MOTOR SKILLS

1. Able to travel independently throughout all Memorial Healthcare facilities.
2. Small motor skills required for operating modern computer, office, and telephone equipment as utilized by Memorial Healthcare (MHC).
3. Lifting drug wholesupply totes (20-30lbs)
4. Standing/sitting/walking for long periods of time (IE: Up to 8 hours)

ESSENTIAL TECHNICAL ABILITIES

1. Proficiency using modern office, computer and telephone equipment as used by Memorial Healthcare.
2. Hybrid role: requires some onsite work

ESSENTIAL MENTAL ABILITIES

1. Ability to adapt and maintain focus in fast paced, quickly changing or stressful situations.
2. Ability to read and interpret a variety of documents including, but not limited to policies, operating instructions, white papers, regulations, rules and laws.
3. Data-driven decision-making

ESSENTIAL SENSORY REQUIREMENTS

1. Able to see for the purpose of reading information received in formats including but not limited to paper, computer, reports, bulletins, updates, manuals.
2. Able to hear for work-related purposes.

INTERPERSONAL SKILLS

1. Ability to interact with co-workers, hospital staff, administration, patients, physicians, the public and all internal and external customers in a professional and effective, courteous and tactful manner, at all times, physically, verbally and in all written and electronic communication.
2. Required to remain calm when adversity is encountered.
3. Open, honest, and tactful communication skills.
4. Ability to work as a team member in all activities.
5. Positive, cooperative and motivated attitude.