Pharmacy Revenue Cycle Analyst

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

Key Responsibilities

Research, resolve, and prepare claims that have not passed payer edits and initiate action to resolve rejected drug claims

Serve as subject matter expert for provider relationships, service issues, reimbursement, and claims

Collaborate with teams to improve denials and avoidable write-offs while monitoring claims for system enhancements

Required Qualifications

Bachelor's degree in Business, Healthcare, or a closely related field, or equivalent work experience

5+ years of experience in healthcare, coding, finance, revenue cycle, patient accounting, and / or physician billing

Certified Pharmacy Technician and / or Certified Coder CPC or RIHT preferred

Advanced knowledge of billing flows, claim edits, and regulatory guidelines

Strong analytical skills and ability to monitor and resolve Claims Work queues