Pharmacy Revenue Cycle Analyst

Job Summary

A company is looking for a Claims Analyst - Pharmacy Revenue Cycle.

Key Responsibilities

• Research and resolve rejected or underpaid pharmacy claims, ensuring accuracy in coding and billing
• Monitor payer edits and recommend improvements to reduce claim denials
• Collaborate with pharmacy and finance teams to minimize denials and support education on revenue cycle processes

Required Qualifications

• Bachelor's degree in Business, Healthcare, or related field, or equivalent work experience
• 1-3 years of experience in healthcare, coding, billing, or pharmacy settings
• Certified Pharmacy Technician (CPhT) or coding certification (CPC, RHIT) preferred
• Strong knowledge of billing flows, payer edits, and Medicare billing unit conversions
• Experience working in Epic or similar healthcare billing systems