Remote Pharmacy Revenue Cycle Specialist

BHS Baptist Healthcare System; Kentucky; Hybrid; USD 65,000 - 90,000; Full time

Job summary

Baptist Health in Kentucky seeks a Remote Pharmacy Revenue Cycle Analyst to ensure optimal revenue capture for pharmacy services. You will analyze inpatient/outpatient billing, manage denials, and support contract negotiations and payment modeling with IT and clinical teams.

Responsibilities include reviewing charges, ensuring accurate CPT/HCPCS coding, and driving first-time quality in revenue cycle metrics. Equal opportunity employer.

Qualifications

• Bachelor's degree and 3 years minimum job-related experience.
• Strong knowledge of general ledger accounts and coding.
• Experience in pharmacy billing and compliance.

Responsibilities

• Analyze and correct claims data to ensure accurate billing.
• Collaborate with accounts receivable for timely billing and follow-up with Medicare, Medicaid, PBMs, and MCOs.
• Reduce denials and underpayments; manage write-offs and appeals as needed.
• Develop and maintain payment models for managed care negotiations and denial management.
• Test and implement software upgrades related to payment modeling.

Skills

Revenue cycle knowledge

Denial management

Billing accuracy

Education

Bachelor's degree

Tools

Epic

Job description

Baptist Health in Kentucky seeks a Remote Pharmacy Revenue Cycle Analyst to ensure optimal revenue capture for pharmacy services. You will analyze inpatient/outpatient billing, manage denials, and support contract negotiations and payment modeling with IT and clinical teams.

Responsibilities include reviewing charges, ensuring accurate CPT/HCPCS coding, and driving first-time quality in revenue cycle metrics. Equal opportunity employer.