Revenue Integrity Specialist - Pharmacy - AM (167)

UAB Medicine; Birmingham (AL); On-site; USD 58,000 - 94,000; Full time

Benefits offered by this job

Educational assistance

Generous paid time off

Wellness programs

Parental leave

Public Service Loan Forgiveness (PSLF)

Job summary

UAB Medicine in Birmingham, AL is seeking a Pharmacy Revenue Cycle Specialist to oversee charge capture and CDM activities, drive audits and data analyses for accurate billing, and collaborate across Pharmacy Operations, Informatics, and Revenue Cycle teams.

The role focuses on compliance, process improvement, and system enhancements to optimize reimbursement and regulatory alignment in a large academic health system.

Qualifications

• Bachelor's degree in Business Administration, Accounting, Finance or a related field.
• Three (3) years of experience in revenue cycle management or related experience required.
• RHIA, RHIT, CCS, CPC/COC/CIC, AAPC, or other coding credentials required; CRCS certifications preferred.

Responsibilities

• Audit and monitor pharmacy charge capture activities to ensure accurate and compliant billing.
• Maintain and update the Pharmacy CDM: codes, revenue codes, pricing changes.
• Investigate and resolve billing discrepancies through review, reconciliation, and data analysis.
• Collaborate with Pharmacy Operations, Informatics, Revenue Cycle, Coding, Compliance, and IS to optimize charging workflows.
• Identify charge leakage and denial trends; recommend and implement process improvements.
• Ensure compliance with federal, state, payer, and organizational billing requirements.

Skills

Revenue cycle management

Education

Bachelor's degree in business/finance

Tools

RHIA

RHIT

CCS

CPC/COC/CIC

AAPC

CRCS

Job description

Position Overview

Pay range: $57,940 - $94,150/ year

Shift: full-time AM

Benefits and perks available for eligible positions include: robust educational assistance programs, generous paid time off, employee assistance and wellness programs, paid parental leave, qualifying employer for the Public Service Loan Forgiveness (PSLF) Program, plus more.

Job Highlights

Responsibilities include:

• Audit and monitor pharmacy charge capture activities to ensure accurate and compliant billing for medications, infusion services, and pharmacy-related procedures.
• Maintain and update the Pharmacy Charge Description Master (CDM), including charge codes, HCPCS codes, revenue codes, and pricing changes.
• Investigate and resolve pharmacy billing, charging, and reimbursement discrepancies through account review, reconciliation, and data analysis.
• Collaborate across teams, including Pharmacy Operations, Pharmacy Informatics, Revenue Cycle, Coding, Compliance, and Information Systems to optimize charge capture workflows.
• Identify charge leakage and denial trends to recommend and implement process improvements that support Revenue Cycle Management (RCM).
• Ensure full compliance with federal, state, payer, and organizational billing requirements and pharmacy charging standards.

Job Description

To promote pharmacy Revenue Cycle Management (RCM) through oversight of charge capture and Charge Description Master (CDM) activities. To conduct audits, reconciliations and data analysis to ensure accurate billing, reimbursement and regulatory compliance. To collaborate with Pharmacy Operations, Pharmacy Informatics, Revenue Cycle, Compliance and Coding teams to optimize charging workflows and resolve billing discrepancies. To support process improvement initiatives, system enhancements, and ongoing compliance with payer and organizational requirements.

Qualifications

Bachelor's degree in Business Administration, Accounting, Finance or a related field and three (3) years of experience in revenue cycle management or related experience required. Work experience may NOT substitute for education requirement. RHIA, RHIT, CCS, CPC/COC/CIC, AAPC, or other coding credentials required. HFMA Certified Revenue Cycle Specialist (CRCS), HFMA Certified Revenue Cycle Specialist (CRCS) certifications preferred.

Why Work at UAB Medicine

We are UAB Medicine, Alabama’s largest and most comprehensive health system, recognized nationally for delivering world-class patient care, pioneering research, and cutting-edge medical education. We proudly serve more than 1.2 million patients each year – from every county in Alabama, all 50 states, and many countries around the world. Our network spans numerous hospitals, emergency departments, many other sites of care, and a team of over 2,000 physicians. Our key facilities include UAB Hospital – ranked the No. 1 hospital in Alabama by U.S. News & World Report and home to the state’s first ACS-verified Level I adult trauma center and only Magnet-designated hospital – along with UAB Hospital-Callahan Eye and five UAB St. Vincent’s hospitals serving central Alabama.

UAB Medicine offers careers across a wide range of practice environments, from our internationally renowned academic medical center and award-winning community hospitals to our primary and specialty care clinics across the state. Whether you’re seeking the fast-paced learning environment of a tertiary care setting or the close-knit environment of a community facility, there’s a place for you on our team where you can become part of a mission-driven organization committed to delivering life-changing care. With nearly every medical specialty represented and unlimited opportunities for growth, you’ll find the right fit for your skills and career goals. We care for you by offering comprehensive, industry-leading benefit packages to support the individual preferences and circumstances of our diverse staff.