Pharmacy Revenue Integrity Lead

1200 MH-Memphis Hospitals

Indianapolis (IN)

On-site

USD 60,000 - 85,000

Full time

7 days ago

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Job summary

Methodist Le Bonheur Healthcare is seeking a Pharmacy Revenue Cycle Specialist to support all phases of the pharmacy revenue cycle, including charge capture, claims submission, denial management, and financial reconciliation. The role may lead Prior Authorization Specialists and coordinate with the Pharmacy Revenue Cycle Analyst to optimize reimbursement and workflows.

The ideal candidate will have a Bachelor’s in Health Science with 1–3 years of pharmacy billing and revenue cycle experience,

Qualifications

Bachelor's Degree in Health Science is required.
Pharmacy billing and revenue cycle experience preferred.
Leadership and strong communication skills are essential.
Familiarity with billing rules and third‑party payor requirements is expected.
Experience with pharmacy systems and billing platforms is advantageous.

Responsibilities

Review and reconcile pharmacy charges for claims submission or resubmission.
Communicate with pharmacy team and insurers to obtain payment, pre-authorization, and resolve patient inquiries.
Monitor Accounts Receivable and Guarantor accounts; assist in denial troubleshooting.
Provide training and guidance to PA team and technicians on billing practices.
Document revenue cycle activities to meet accrediting and regulatory requirements.