Revenue Integrity & CDM Analyst (Pharmacy)

Regional One Health; Memphis (TN); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

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Job summary

Regional One Health in Memphis, TN seeks a Pharmacy Revenue Integrity Analyst to oversee charging and billing accuracy across pharmacy operations. You will partner with Pharmacy, Finance and ancillary teams to ensure compliant revenue capture and reporting.

The role emphasizes reviewing billing edits, maintaining the CDM, analyzing denial trends, and educating staff on correct charge capture. Strong analytical skills, a pharmacy tech license, and experience with billing systems are required.

Qualifications

• Associate's or Bachelor's degree required.
• Certified Pharmacy Technician license required.
• Minimum 2 years of related experience including pharmacy operations and financial analysis.

Responsibilities

• Performs financial review and analysis to resolve billing edits blocking claims.
• Interact with ancillary departments to obtain billing information from medical records.
• Identify charging, coding, or documentation issues and resolve with leadership.
• Review denial trends for opportunities to improve documentation and charging.
• Audit processes and enter corrections into systems to improve flow of claims.
• Coordinate education on charging and billing with inpatient and ancillary staff.
• Ensure accuracy of all medication charges and CDM maintenance.

Skills

Analytical skills

Billing knowledge

Financial analysis

Education

Associate's Degree in Business Administration with emphasis in Finance, Accounting, HealthCare Administration/Management or Economics

Bachelor's Degree in Business Administration with emphasis in Finance, Accounting, HealthCare Administration/Management or Economics

Tools

CDM system

Charge Master

Billing software

Job description

Regional One Health in Memphis, TN seeks a Pharmacy Revenue Integrity Analyst to oversee charging and billing accuracy across pharmacy operations. You will partner with Pharmacy, Finance and ancillary teams to ensure compliant revenue capture and reporting.

The role emphasizes reviewing billing edits, maintaining the CDM, analyzing denial trends, and educating staff on correct charge capture. Strong analytical skills, a pharmacy tech license, and experience with billing systems are required.