ChargeMaster, Revenue Integrity Analyst (Pharmacy Tech)

About the position

The ChargeMaster, Revenue Integrity Analyst (Pharmacy Tech) at Regional One Health is responsible for ensuring the integrity of billing and revenue processes related to pharmacy operations. This role involves analyzing financial data, resolving billing issues, and serving as a liaison between pharmacy, finance, and ancillary departments to enhance revenue management initiatives. The analyst will also coordinate educational efforts and maintain compliance with regulatory guidelines.

Responsibilities

• Perform financial review and analysis to resolve billing edits holding patient claims from billing.
• Interact with ancillary departments to obtain additional information for proper billing based on medical records.
• Identify and resolve charging, coding, or clinical documentation issues with ancillary departments.
• Review denial trends for documentation or charging issue opportunities.
• Conduct assigned audits by researching documentation and making recommendations for improvement.
• Serve as a liaison for regular reviews of CPT codes and revenue codes, and communicate with ancillary departments to resolve issues.
• Coordinate educational in-services for Inpatient Pharmacy and Ancillary staff regarding charging and billing issues.
• Assess the accuracy of all medication charges and perform balancing of charge posting from clinical and ancillary systems.
• Evaluate current charging and coding structures to ensure compliance with government and third-party payor requirements.
• Analyze changes to coding and billing rules and regulations using various resources.
• Provide guidance and education on correct charge capture, coding, and billing processes to finance and ancillary staff.
• Oversee the Pharmacy Charge Description Master (CDM) and monitor synchronization of item masters.
• Coordinate and communicate medication revisions in accordance with policies and procedures.
• Utilize operational knowledge to ensure compliance with guidelines and interpret regulations.
• Research charging regulations as required and provide technical direction to users.
• Analyze and present financial information and summary reports to management.
• Prepare and analyze financial models of current operations and generate comprehensive reports for decision-making.
• Collaborate with various departments on revenue management initiatives and maintain compliance records.

Requirements

• Associate's Degree in Business Administration with emphasis in Finance, Accounting, Healthcare Administration/Management or Economics.
• Bachelor's Degree in Business Administration with emphasis in Finance, Accounting, Healthcare Administration/Management or Economics (preferred).
• Certified Pharmacy Technician upon hire.
• State Board of Tennessee Board of Pharmacy Certified Pharmacy Technician License upon hire.
• Minimum of 2 years experience in pharmacy operations, financial analysis, database development, and report generation.

Nice-to-haves

• Experience with CPT coding and healthcare compliance regulations.
• Strong leadership skills and ability to train staff on new processes.

Benefits

• Health insurance
• Dental insurance
• 401k retirement plan
• Paid holidays
• Flexible scheduling
• Professional development opportunities