Analyst, Pharmacy Revenue Cycle

📋 Description

• • The Analyst, Pharmacy Revenue Cycle provides analytical support for pharmacy-related charges and revenue under the supervision of the Pharmacy Revenue Cycle Manager, ensuring accurate billing, reimbursement, and client payables while maintaining compliance with department policies and hospital standards.
• • Day-to-day responsibilities include collaborating with Compliance Analysts to identify prescriptions, developing processes for tracking pharmacy and client prescriptions, utilizing pharmacy dispensing software to re-bill claims, preparing and maintaining reports or dashboards, contacting insurance companies to resolve claim denials, auditing claims for accuracy, monitoring hospital drug charge edits, collaborating with Revenue Integrity and Billing teams, performing month-end reconciliations, preparing and submitting monthly client payables to Accounts Payable, conducting research and special projects, participating in hospital-wide quality improvement activities, and mentoring Pharmacy Revenue Cycle Associates.
• • The role operates within BMC Software, Inc.’s Pharmacy Revenue Cycle department, which focuses on optimizing revenue streams for pharmacy services through accurate billing, claims management, and financial reconciliation, supporting hospital departments, contract pharmacies, and clients with a commitment to ethical standards and patient-centered care.
• • The analyst will develop expertise in pharmacy billing and reimbursement, gain experience in revenue cycle management, enhance analytical and reporting skills using data tools, strengthen communication and collaboration across clinical and financial teams, and contribute to process improvements that ensure timely and accurate client payments while upholding BMC’s RESPECT behavioral standards.