Pharmacist

Pride Health; Boston (MA); Remote; USD 100,000 - 125,000; Full time

Job summary

An innovative healthcare organization is seeking a Claims Analyst for Pharmacy Revenue Cycle to join their remote team. This role involves resolving pharmacy claims, ensuring compliance with billing regulations, and collaborating with pharmacy teams to enhance workflows. Ideal candidates will have a Bachelor's degree in business or healthcare and 1-3 years of relevant experience in healthcare coding or revenue cycle management. Join a top-tier organization that values diversity and offers a comprehensive benefits package, including medical, dental, and vision insurance, along with tuition reimbursement opportunities. This is a fantastic chance to grow your career in a supportive environment.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Flexible Spending Accounts

Life Insurance

Long-term Disability Insurance

Short-term Disability

403b Retirement Plan

Tuition Reimbursement up to $4,000 annually

Qualifications

• 1-3 years of experience in healthcare, coding, or revenue cycle.
• Bachelor's degree or equivalent work experience required.

Responsibilities

• Resolve pharmacy claims and improve reimbursement outcomes.
• Ensure accurate billing and compliance with regulations.
• Collaborate with pharmacy teams to reduce claim denials.

Skills

Healthcare Coding

Revenue Cycle Management

Billing Compliance

Claims Resolution

Collaboration

Education

Bachelor's degree in Business or Healthcare

Equivalent work experience

Job description

This range is provided by Pride Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$32.00/hr - $33.00/hr

Pride Health is hiring a Claims Analyst Pharmacy Revenue Cycle to support our client’s medical facility based in Boston, MA. This Remote opportunity is a great way to start working with a top-tier healthcare organization!

Responsibilities:

• Claims Research & Resolution: Resolve pharmacy claims that fail payer edits and address rejected drug claims, identifying system fixes to prevent future issues.
• Billing & Compliance: Ensure accurate pharmacy billing, applying Medicare, Medicaid, and third-party payer codes, and verifying compliance with regulations before submission.
• Collaboration with Pharmacy Team: Work with pharmacy teams to resolve revenue cycle issues, enhance workflows, and reduce claim denials and rejections.
• Denial Management & Follow-up: Monitor and follow up on outstanding pharmacy-related claims and balances, improving reimbursement outcomes.
• Process Improvement: Identify and implement changes to enhance pharmacy billing workflows, reduce errors, and prevent claim rejections.
• Regulatory Expertise: Stay current on pharmacy-specific billing codes and regulatory changes, serving as a subject matter expert for pharmacy-related denials and payment issues.

Qualifications:

• Bachelor's degree in business, Healthcare or closely related field or equivalent work experience.
• 1 to 3 years of experience in healthcare, coding, finance, revenue cycle, patient accounting and/or physician billing, preferably in Medical Center setting, Oncology or Home/Office Infusion setting.

Job Type: Contract

Schedule: 5x8

Pay Range: $33/ hour

*Offered pay rate will be based on education, experience, and healthcare credentials.

Pride Health provides a comprehensive benefits package, including medical, dental, and vision insurance, flexible spending accounts, company-paid life and long-term disability insurance, and optional supplemental life insurance for employees, spouses, and children. Additional perks include short-term disability, accident and critical illness coverage, identity theft protection, a 403b retirement plan, and tuition reimbursement of up to $4,000 annually for full-time employees.

Interested? Apply now!

About Pride Health:

Pride Health is Pride Global's healthcare staffing branch, providing recruitment solutions for healthcare professionals and the industry at large since 2010.

Equal Employment Opportunity Statement:

As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.

Seniority level

Associate

Employment type

Contract

Job function

Health Care Provider

Industries

Hospitals and Health Care and Public Health