Senior Reimbursement Analyst

Beth Israel Lahey Health; Westwood (KY); On-site; USD 72,000 - 96,000; Full time

Job summary

Beth Israel Lahey Health is seeking a Pharmacy Revenue Cycle Analyst to optimize reimbursement and revenue integrity across the pharmacy enterprise. You will analyze denials, underpayments, rebates, and payer performance while supporting analytics and reporting for stakeholders.

You will collaborate with Pharmacy Operations, Finance, Revenue Cycle, and IS teams to drive financial improvements and stay current on policy changes affecting reimbursement.

Qualifications

• Bachelor's degree required in Finance, Business, Healthcare Administration, Pharmacy Administration, or related field.
• 3+ years of healthcare revenue cycle, pharmacy finance, specialty pharmacy, infusion reimbursement, or healthcare analytics experience.
• Advanced Excel and data analytics skills with ability to translate complex data into actionable insights.
• Strong analytical, organizational, problem-solving, and project management skills.
• Demonstrated ability to manage multiple priorities while maintaining accuracy.

Responsibilities

• Analyze pharmacy reimbursement, denials, underpayments, and accounts receivable trends to identify revenue recovery and optimization opportunities.
• Perform analytics, rebate reconciliation, dispute management, and financial performance reporting.
• Analyze 340B and MFP rebate eligibility, reimbursement, and payment variances within pharmacy systems; prepare and submit appeals and disputes to manufacturers, payers, and third-party administrators to ensure accurate rebate capture and revenue recovery.
• Investigate payer denials and underpayments, prepare appeals, and coordinate resolution with payers and internal stakeholders.
• Support medication charge capture, reimbursement integrity, and pharmacy revenue cycle process improvements.
• Develop dashboards and reports tracking reimbursement performance, denials, rebates, payer trends, and key pharmacy financial indicators.
• Collaborate with pharmacy leadership, finance, contracting, and revenue cycle teams to improve operational and financial outcomes.
• Stay current on pharmacy reimbursement regulations, payer policies, 340B requirements, and Medicare reimbursement changes.

Skills

Advanced Excel

Data analytics

Financial analysis

Attention to detail

Project management

Education

Bachelor's degree in Finance, Business, Healthcare Administration, Pharmacy Administration, or related field

Job description

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

The Pharmacy Revenue Cycle Analyst, under the direction of the Revenue Cycle Manager-Pharmacy, supports the financial performance of a large health system pharmacy enterprise by analyzing reimbursement, billing, revenue cycle operations, and payer performance across specialty pharmacy, infusion, retail, and provider-administered drug services. This role partners with Pharmacy Operations, Finance, Revenue Cycle, and Information Systems teams to optimize reimbursement, ensure revenue integrity, and identify revenue enhancement opportunities.

Job Description

Essential Responsibilities

• Analyze pharmacy reimbursement, denials, underpayments, and accounts receivable trends to identify revenue recovery and optimization opportunities.
• Perform analytics, rebate reconciliation, dispute management, and financial performance reporting.
• Analyze 340B and MFP rebate eligibility, reimbursement, and payment variances within pharmacy systems; prepare and submit appeals and disputes to manufacturers, payers, and third-party administrators to ensure accurate rebate capture and revenue recovery.
• Investigate payer denials and underpayments, prepare appeals, and coordinate resolution with payers and internal stakeholders.
• Support medication charge capture, reimbursement integrity, and pharmacy revenue cycle process improvements.
• Develop dashboards and reports tracking reimbursement performance, denials, rebates, payer trends, and key pharmacy financial indicators.
• Collaborate with pharmacy leadership, finance, contracting, and revenue cycle teams to improve operational and financial outcomes.
• Stay current on pharmacy reimbursement regulations, payer policies, 340B requirements, and Medicare reimbursement changes.

Required Qualifications

• Bachelor's degree in Finance, Business, Healthcare Administration, Pharmacy Administration, or related field.
• 3+ years of healthcare revenue cycle, pharmacy finance, specialty pharmacy, infusion reimbursement, or healthcare analytics experience.
• Advanced Excel and data analytics skills with the ability to translate complex data into actionable insights.
• Strong analytical, organizational, problem-solving, and project management skills.
• Demonstrated ability to manage multiple priorities while maintaining attention to detail and accuracy.

Pay Range

$72,000.00 USD - $96,000.00 USD The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

Equal Opportunity Employer/Veterans/Disabled

At Beth Israel Lahey Health, we are driving the change in health care that Massachusetts wants and needs.

Our culture promotes continuous learning, growth, innovation and a sense of belonging. We make it a priority to offer comprehensive compensation and benefits and help you achieve a healthy and balanced life. While you're busy caring for and supporting our patients, we take care of you.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.