Charge Reconciliation and 340B Compliance Specialist

If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk? Bayhealth Medical Center is Central and Southern Delaware's healthcare leader with hospitals in Dover and Milford, as well as stand-alone Emergency Department in Smyrna and a hybrid Emergency Department and Urgent Care in Milton. We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore. Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand! Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including: Generous Paid Time Off and Paid Holidays Matching 401(k)/403(b) Plans Excellent Health, Dental, and Vision Disability and Life Insurance options On Site Child Care Educational Reimbursement Health Care and Dependent Care Flex Spending Accounts Plus, an array of Voluntary Benefits to include Critical Care Coverage and more! Location: Kent Campus HospitalStatus: Full Time 80 HoursShift: Day/ EveningSALARY RANGE: 25.71 - 38.56HOURLYGeneral Summary:The Charge Reconciliation and 340B Specialist works under the general supervision of the Pharmacy Business Manager and is responsible for charge reconciliation and contract management in the pharmacy department. In addition, this employee is also responsible for maintaining, problem-solving, and auditing of the pharmacy's 340B contract pharmacies. Responsibilities:1. Manages pharmacy charge work queue and monitors and maintains accurate pharmacy charge capture: a) Processes and audits patient charges related to pharmacy.b) Assures that all charges and credits are completed within the allotted four-day window to minimize late charges from the pharmacy department.c) Reviews daily charges to look for excessive charges and/or quantities.d) Makes all necessary corrections to pharmacy charges and date of service billing error for patient accounts as communicated by members of the finance billing department.e) Assures charges are input into an automated system for patient care/outpatient and diagnostic areas. For example, the processing of anesthesia charges on a daily basis. 2. Monitors pharmacy claim edit work queue and communicates with patient financial services to adjudicate billing errors and discrepancies. a) Processes denials for pharmacy claims rejected by third party payers for resubmission of payment.b) Works closely with patient financial services to resolve claim discrepancies in a timely fashion.c) Assists internal audit team in researching and resolving audit discrepancies. 3. Manages internal and external department charging for the pharmacy to assure hospital charges are in accordance with hospital policy:a) Maintains and posts interdepartmental charges for both Kent and Milford campuses.b) Maintains and posts charges for Bayhealth Physician Offices and other vendors outside of the hospitals that purchase products from the pharmacy. c) Maintains and posts all interdepartmental charges with minimal errors. 4. Maintains departmental files in accordance with pharmacy policies and procedures:a) Sets up and maintains various department manuals and filing systems in accordance with department manuals and paper/computerized filing systems in accordance with JCAHO/HRSA record keeping requirements.b) Properly maintains files for anesthesia and contract management charges.c) Properly maintains files for monthly pharmacy inventory inspections in accordance with departmental policies. 5. Monitors and coordinates 340B contract pharmacy audits per 340B policies and procedures:a) Track and Monitor the in-house specialty pharmacy transaction to Validate and approve 340B eligibilityb) Conducts a monthly audit of all contract and in-house pharmacies and documents results accordingly. Reports all findings to the pharmacy business manager and 340B Oversight Committee. c) Responsible for tracking and monitoring contract and in-house pharmacy purchases and ensuring appropriate charging. d) Responsible for monitoring and maintaining various 340B administrative programs for each respective contract pharmacy (ie. Macrohelix, Capture Rx, etc.)e) Participates in monthly 340B Oversight Committee meetings.6. Evaluates new 340B contract pharmacies opportunities per departmental policies and procedures:a) Researches and communicates with local pharmacies to determine appropriateness of 340B contracting opportunities.b) Participates in ensuring interface compliance of all new contract pharmacy systems along with the pharmacy business manager.c) Ensures accurate reporting of contract pharmacy relationships on the HRSA website. 7. Maintaining of EPIC inventory system to ensure utilization of the full functionality of the programa) Ensure EPIC inventory workflow is followed & optimized (routine orders are initiated and received via EPIC inventory for proper inventory update, maintain/clean outgoing request work queue) b) Correcting negative balances, investigate the cause for negative balances, create IT ticket for any EPIC inventory functionality build issue, setting/optimizing/cleaning missing pars (min, critical & optimum), daily review of balance change from cycle count and fixing the cause for the discrepancy, Random spot checking of inventory counts of items prone to discrepancies (inventory tracking per unit Vs gm (inhalers), inventories with decimal numbers etc), review cycle count percentage & report to business supervisor for any gap/discrepancies.c) Review inventory clinic request fulfilment & charge quantity discrepancies & generate charge reports (GL report) to finance once a month based on EPIC inventory Transfer Report 8. All other duties as assigned within the scope and range of job responsibilities.Required Education, Credential(s) and Experience:Education: Associate DegreeCredential(s): Certified Pharmacy TechnicianExperience: Required: Minimum of 5 years experience as a pharmacy technician or relevant work experience (340B, Billing).Preferred Education, Credential(s) and Experience:Education: Credential(s): Experience: Preferred: 5 years of work experience as a certified technician and 2 years as a charge reconciliation specialist; experience working with the 340B drug program.To view a full list of all open position at Bayhealth, please visit:

Created: 2026-04-02