Pharmacy Audit and Reconciliation Coordinator

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Job Title:

Pharmacy Audit and Reconciliation Coordinator

Department:
Retail Rx | OSU Outpatient Pharmacy

The Revenue Integrity Specialist optimizes the payment cycle for retail and specialty pharmacy claims. This role ensures accurate workflow of pharmacy accounts, reviews payments for accuracy, aligns collections with contracts, and follows up with insurance companies. The specialist secures third-party payments, ensures compliance with payer contracts, and maintains accurate secondary billing processes and vendor data feeds. They advocate for efficient claim resolution, provide proactive follow-up, and identify trends to ensure process accuracy.

Additionally, they contribute to scalable process improvements, respond to and defend audit requests from commercial health plans/payors, and ensure the accuracy and completeness of claims to retain reimbursement.

The Ohio State University (OSU) Outpatient Pharmacy’s mission is to improve people’s lives through pharmacy practice innovation, comprehensive medication education, and collaborative clinical and practice research. The OSU Outpatient Pharmacy generates more $250M in annual revenue and processes more than
250,000claims at 8 pharmacy locations. This position will provide claims reconciliation, claims filing, audit support and response and reimbursement challenges for all 8 OSU Outpatient Pharmacy sites.

Bachelor's Degree or equivalent combination of education and experience. Certified Pharmacy Technician. 2 years of relevant experience required. 2-4 years of relevant experience preferred.

Location:

Ackerman Rd, 660 (0242) Position Type:
Regular Scheduled

Hours:

40 Shift: Varying Shifts Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.

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The university is an equal opportunity employer, including veterans and disability. At Ohio State, you’ll find work that inspires you. We offer roles and growth opportunities in countless fields and specialties - including a job that’s right for you. Ohio State benefits give you options to take care of what matters most to you - and opportunities to make adjustments as your life and needs change, including:

• Medical, dental and vision coverage, with Ohio State paying a significant portion of the cost.
• Paid time off, including sick and vacation time…