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Revenue Integrity Specialist - Pharmacy - AM (167)

$57.94k - $94.15k

UAB Medicine

Pharmacy Revenue Cycle Management AuditorPay range: $57,940 - $94,150/ yearShift: full-time AMBenefits 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 HighlightsResponsibilities 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 DescriptionTo 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.QualificationsBachelor'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 MedicineWe 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.

Vacancy posted 1 day ago
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