Specialist, Retail Pharmacy Revenue - Retail Pharmacy - Mullica Hill

INSPIRA HEALTH NETWORK LIFE INC; Mullica Hill (NJ); On-site; USD 70,000 - 90,000; Full time

Job summary

Inspira Health is seeking a Retail Pharmacy Revenue Cycle Specialist in New Jersey to drive A/R follow-up, payment posting, denial resolution, and reconciliation within Epic Willow Ambulatory and PB workflows. The role partners with Pharmacy, Revenue Cycle, and Finance to ensure accurate revenue capture and timely cash flow.

Qualified candidates have an Associate’s or Bachelor’s degree and 2+ years in healthcare billing or revenue cycle operations; experience with PBM workflows and EHR systems

Qualifications

• Education in business, healthcare administration, or related field required.
• 2+ years in healthcare billing, accounts receivable, pharmacy operations, or related healthcare financial operations required.
• Experience with PBM workflows, remittance reconciliation, or denial management preferred.

Responsibilities

• Execute and perform retail pharmacy revenue cycle operations within Epic Willow Ambulatory and PB.
• Own accounts receivable follow-up, payment posting, denial resolution, and payment reconciliation to ensure accurate revenue capture.
• Collaborate with Pharmacy, Revenue Cycle, and Finance to align claim adjudication and remittance processing.

Skills

Revenue cycle knowledge

A/R follow-up

Payment posting

Denial management

EHR navigation

Analytical skills

Cross-functional collaboration

Education

Associate’s degree

Bachelor’s degree

Tools

Epic Willow Ambulatory (WAM)

Job description

Major Function

The Retail Pharmacy Revenue Cycle Specialist is responsible for execution and performance of retail pharmacy revenue cycle operations within Epic Willow Ambulatory (WAM) and Professional Billing (PB). This role owns accounts receivable (A/R) follow-up, payment posting, denial resolution, and payment reconciliation activities to ensure accurate and timely revenue capture for retail pharmacy services.

The position plays a critical role in Inspira Health’s transition from third-party A/R management to an internally operated Epic-based revenue cycle model. The Specialist serves as a key operational liaison between Pharmacy, Revenue Cycle, and Finance, ensuring alignment of claim adjudication, remittance processing, and reconciliation workflows. This role directly contributes to AR reduction, denial prevention, cash acceleration and overall revenue integrity.

This role is accountable for identifying reimbursement variances and supporting recovery of underpayments and unresolved accounts receivable.

Qualifications

Education & Experience:

• 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

Certification/Licensure

• NJ Pharmacy Technician License required within 180 days.
• Certified Pharmacy Technician (PTCB, NHA, or ASHP/ACPE) required
• RHIT/RHIA or Coding Certification (CCS, CPC, COC) required
• PTCB Billing and Reimbursement certificate preferred.

Knowledge & Skills

• Strong understanding of healthcare revenue cycle processes, including claim adjudication, payment posting, and denial management
• Ability to analyze and reconcile financial transactions with high accuracy
• Proficiency in navigating workqueue-driven workflows within electronic health record systems
• Strong problem-solving and analytical skills
• Effective communication and collaboration across operational and financial teams

Physical Requirements

Place an N, O, F or C in the boxes below

N: Never O: Occasionally (<20%) F: Frequently (20%-80%) C: Constantly >80%)

Lifting <20lbs O Standing O Sitting O

Lifting 20-50lbs O Climbing O Kneeling O

Lifting >50lbs O Crouching O Reaching O

Carrying O Hearing O Walking O

Pushing O Talking O Vision O

Environmental Conditions

Noise O Varied Temperatures O Cleaning Agents O

Noxious odors O Patient Exposure O Operative Equipment O

At Inspira Health

you’ll join with the area’s most dedicated and distinguished team to bring quality and compassionate care to our communities.

We focus on clinical excellence, providing evidence-based care to help each patient achieve the best possible outcome.

The scope and depth of our network can open many doors for your learning and career growth.

Our charitable nonprofit health care organization serves communities across southern New Jersey. The network, which traces its roots to 1899, comprises three hospitals, a comprehensive cancer center, sleep medicine, cardiac testing, digestive health and wound care, urgent care, imaging and rehabilitation, and primary and specialty physician practices in Gloucester, Cumberland, Salem and Camden counties.

Inspira is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, creed, color, national origin, ancestry, age, marital status, affectional or sexual orientation, familial status, disability, liability for service in the Armed Forces of the United States, nationality, sex, gender identity or expression.