Pharmacy - Pharmacist

Cynet Health; Roseville (CA); On-site; USD 55,000 - 83,000; Full time

Job summary

Cynet Health is seeking a Pharmacy - Pharmacist for a 13-week, day-shift assignment. The role focuses on system pharmacy charge & compliance analysis, ensuring accurate charge capture, billing, and reimbursement across outpatient hospital departments.

Provides guidance to bridge pharmacy operations with revenue cycle and compliance teams. The ideal candidate has 3+ years in hospital/health system pharmacy, with a licensed State Pharmacy Technician credential and preferred board certifications

Qualifications

• Three years of experience in hospital or health system pharmacy, revenue integrity, billing, or compliance required.

Responsibilities

• Supports accurate and compliant medication charging, billing, and reimbursement across outpatient hospital departments.
• Ensures medication-related charges are complete, accurate, compliant, and aligned with regulatory requirements.
• Serves as the bridge between pharmacy operations, revenue cycle, compliance, and finance.
• Reviews and reconciles medication charges in outpatient hospital encounters.
• Identifies and corrects charge capture errors prior to billing to ensure clean claims submission.

Skills

Hospital pharmacy experience

Education

State Pharmacy Technician license

Pharmaceutical Technician Board certification

Advanced certification (CHRI/CRCR/340B ACE)

Job description

Pharmacy - Pharmacist

Profession: System Pharmacy Charge & Compliance Analyst

Specialty: System Pharmacy Charge & Compliance Analyst

Duration: 13 weeks

Shift: Day Shift

Hours per Shift: 40 hours per week, Monday - Friday, 7:00 AM - 3:30 PM

Experience: Three years of experience in hospital or health system pharmacy, revenue integrity, billing, or compliance required

License: State Pharmacy Technician license required

Certifications: Pharmaceutical Technician Board certification preferred, Advanced certification (e.g., CHRI, CRCR, or 340B ACE) preferred

Description:Supports accurate and compliant medication charging, billing, and reimbursement across outpatient hospital departments.Ensures medication-related charges are complete, accurate, compliant, and aligned with regulatory requirements.Serves as the bridge between pharmacy operations, revenue cycle, compliance, and finance.Uses a deep understanding of pharmacy workflows, coding, charge capture, and payer requirements to prevent revenue leakage and mitigate compliance risks.Reviews and reconciles medication charges in outpatient hospital encounters.Validates NDC-to-HCPCS mapping, billable units, and appropriate modifiers per guidelines.Ensures compliance with pricing policies and collaborates with program integrity teams to maintain audit readiness.Participates in internal and external audits.Identifies and corrects charge capture errors prior to billing to ensure clean claims submission.Monitors claim accuracy for outpatient medication billing and ensures alignment with clinical documentation.Collaborates with relevant teams to maintain compliant and optimized charge description master entries for medications.Stays current on outpatient prospective payment system updates and payer-specific requirements.Supports resolution of claim denials related to outpatient drug charges, waste modifiers, medical necessity, or coding errors.Performs root cause analysis of denied or underpaid medication claims and recommends preventive actions.Partners with teams to adjust, rebill, or appeal denied medication claims when appropriate.Works with procurement teams to understand medication usage patterns and potential billing impacts.Serves as a subject matter expert for medication charge capture during EMR upgrades and workflow changes.Assists in the design and maintenance of charge automation rules and EMR charge capture mapping.Educates staff on charge accuracy, compliance, and billing best practices.Tracks and reports charge correction trends and reimbursement impact.Identifies systemic issues and recommends process improvements to reduce recurring errors.Performs other job-related duties as assigned.Organizational Requirements:Commitment to safety and well-being of associates and patients.Compliance with vaccination requirements as a condition of employment.Participation in E-Verify process is required.