Licensing Specialist at KPH… · East…

Summary: KPH Healthcare Services, Inc is seeking a Licensing Specialist to assist in maintaining all Pharmacy Licensing and credentialing necessary for their business model. The role involves working collaboratively with Third Party Business Partners and Government Agencies to ensure compliance with licensing requirements and support the Third-Party Administrator in various tasks. Responsibilities: - Responsible for the submission of Medicare/Medicaid Revalidations, Change of Information applications and general compliance - Responsible for notifying stores of changes to existing plans, acceptance of new plans and terminations of plans - Responsible for resolving Third Party pharmacy questions received from Store Systems Help Desk - Responsible for maintaining licensing and credentialing in NCPDP - Responsible for maintaining NPPES application - Responsible for maintaining a Master Store List of all divisions - Responsible for yearly renewal process for DEA Certificates and Meth Certificates - Responsible for yearly Primary Source Validations - Assist Third Party Administrator with licensing and credentialing - Assist Third Party Administrator/Pharmacy Reimbursement Specialist in the review of plan set up within the pharmacy application - Assist Third Party Administrator for tracking, maintaining, and renewing store pharmacies registrations, new store registrations, licenses, and DEA Certificates - Assist Pharmacy Reimbursement Specialist with change of Supervising Pharmacist process - Assist Pharmacy Reimbursement Specialist with yearly immunization Third Party configuration - Perform other duties as assigned Required Qualifications: - Works under general supervision of Third-Party Administrator - Uses experience and judgment to plan and accomplish assigned tasks and goals - Works collaboratively within the department, with Third Party Business Partners as well as Government Agencies to ensure licensing, credentialing and all necessary paperwork are in place for billing - Responsible for the submission of Medicare/Medicaid Revalidations, Change of Information applications and general compliance - Responsible for notifying stores of changes to existing plans, acceptance of new plans and terminations of plans - Responsible for resolving Third Party pharmacy questions received from Store Systems Help Desk - Responsible for maintaining licensing and credentialing in NCPDP - Responsible for maintaining NPPES application - Responsible for maintaining a Master Store List of all divisions - Responsible for yearly renewal process for DEA Certificates and Meth Certificates - Responsible for yearly Primary Source Validations - Assist Third Party Administrator with licensing and credentialing - Assist Third Party Administrator/Pharmacy Reimbursement Specialist in the review of plan set up within the pharmacy application - Assist Third Party Administrator for tracking, maintaining, and renewing store pharmacies registrations, new store registrations, licenses, and DEA Certificates - Assist Pharmacy Reimbursement Specialist with change of Supervising Pharmacist process - Assist Pharmacy Reimbursement Specialist with yearly immunization Third Party configuration - Perform other duties as assigned - Minimum: High School Diploma or GED - Drug Test - Initial and continuous exclusion and sanction/disciplinary monitoring Preferred Qualifications: - Previous experience in retail pharmacy, Third Party operations, and/or Finance/Accounting - Preferred: AS Degree or Higher in Business Administration, or related field Required Skills: Medicare/Medicaid Revalidations, NCPDP, NPPES application, DEA Certificates, Meth Certificates, Primary Source Validations, Pharmacy Licensing, Credentialing, Pharmacy Reimbursement, Store Pharmacy Registrations