Retail Pharmacy Revenue Optimizer (A/R & Denials)

Inspira Health Network; Mullica Hill (NJ); On-site; USD 70,000 - 95,000; Full time

Job summary

Inspira Health Network in Mullica Hill, NJ seeks a Retail Pharmacy Revenue Cycle Specialist to manage AR follow-up, payment posting, denial resolution within Epic Willow Ambulatory (WAM) and PB.

You will serve as a liaison between Pharmacy, Revenue Cycle, and Finance to ensure accurate remittance processing, reconciliation, and revenue integrity. This on-site, full-time role supports cash acceleration and authorized payment resolution.

Qualifications

• Associate's or Bachelor's degree in Business, Healthcare Administration, or related field required.
• Minimum 2 years of experience in healthcare billing, accounts receivable, pharmacy operations, revenue cycle, claims adjudication, or related healthcare financial operations required.
• Experience with pharmacy billing, PBM workflows, prior authorization processes, remittance reconciliation, or denial management strongly preferred.
• Experience interpreting EOBs, claim edits, payment variances, or 835 remittance transactions preferred.
• Experience working within Epic, electronic health records, pharmacy systems, or healthcare financial systems preferred.
• Prior retail pharmacy, ambulatory pharmacy, managed care, health information management, or healthcare reimbursement experience preferred

Responsibilities

• Execute and monitor retail pharmacy revenue cycle operations within Epic Willow Ambulatory and PB.
• Own accounts receivable follow-up, payment posting, denial resolution, and payment reconciliation for retail pharmacy services.
• Identify reimbursement variances and support recovery of underpayments and unresolved AR.
• Serve as liaison between Pharmacy, Revenue Cycle, and Finance to align claim adjudication and remittance workflows.
• Contribute to AR reduction, denial prevention, and cash acceleration.

Skills

Healthcare revenue cycle

Payment posting

Denial management

EOB/remittance reconciliation

Epic Willow Ambulatory / EHR

Analytical problem-solving

Education

Associate's or Bachelor's degree in Business/Healthcare Administration

Tools

Epic

Pharmacy systems

Remittance software

835 remittance processing

Job description

Inspira Health Network in Mullica Hill, NJ seeks a Retail Pharmacy Revenue Cycle Specialist to manage AR follow-up, payment posting, denial resolution within Epic Willow Ambulatory (WAM) and PB.

You will serve as a liaison between Pharmacy, Revenue Cycle, and Finance to ensure accurate remittance processing, reconciliation, and revenue integrity. This on-site, full-time role supports cash acceleration and authorized payment resolution.