Pharmacy - Pharmacist

System Pharmacy Charge & Compliance Analyst

Supports accurate and compliant medication charging, billing, and reimbursement across outpatient hospital departments. Ensures medication-related charges are complete, accurate, compliant, and aligned with regulatory requirements. Serves as the bridge between pharmacy operations, revenue cycle, compliance, and finance. Uses a deep understanding of pharmacy workflows, coding, charge capture, and payer requirements to prevent revenue leakage and mitigate compliance risks. Reviews and reconciles medication charges in outpatient hospital encounters. Validates NDC-to-HCPCS mapping, billable units, and appropriate modifiers per guidelines. Ensures compliance with pricing policies and collaborates with program integrity teams to maintain audit readiness. Participates in internal and external audits. Identifies and corrects charge capture errors prior to billing to ensure clean claims submission. Monitors claim accuracy for outpatient medication billing and ensures alignment with clinical documentation. Collaborates with relevant teams to maintain compliant and optimized charge description master entries for medications. Stays current on outpatient prospective payment system updates and payer-specific requirements. Supports resolution of claim denials related to outpatient drug charges, waste modifiers, medical necessity, or coding errors. Performs root cause analysis of denied or underpaid medication claims and recommends preventive actions. Partners with teams to adjust, rebill, or appeal denied medication claims when appropriate. Works with procurement teams to understand medication usage patterns and potential billing impacts. Serves as a subject matter expert for medication charge capture during EMR upgrades and workflow changes. Assists in the design and maintenance of charge automation rules and EMR charge capture mapping. Educates staff on charge accuracy, compliance, and billing best practices. Tracks and reports charge correction trends and reimbursement impact. Identifies systemic issues and recommends process improvements to reduce recurring errors. Performs other job-related duties as assigned.

Organizational Requirements: Commitment to safety and well-being of associates and patients. Compliance with vaccination requirements as a condition of employment. Participation in E-Verify process is required.

We offer competitive benefits, including:

• Medical, dental & vision insurance
• Free and unlimited continuing education units (CEUs)
• 24/7 dedicated Care Line and clinical liaison support
• Personalized career consultant and "single point of contact" service
• Industry‑leading pay rates, loyalty rewards & referral bonuses
• Free tax return assistance for travelers
• 401(k) Retirement Plan
• Health Savings Account (HSA)
• Disability Insurance (Short-Term and Long-Term)
• Life and AD&D Insurance
• Paid Sick Leave (where required by applicable state or local law)
• Supplemental Insurance Plans
• Identity Theft Protection
• Pet Insurance
• Employee Wellness Programs
• Employee Assistance Program (EAP)
• Career Growth and Professional Development Opportunities

Disclaimer: Benefits eligibility, accrual rates, and usage limits may vary based on employment status, length of service, and work location. Paid Sick Leave is provided in strict accordance with applicable state and municipal mandates. Cynet Health reserves the right to modify, amend, or terminate any benefit plans at any time in accordance with applicable laws.

Cynet Health is a Joint Commission-accredited, Minority-Owned healthcare staffing agency headquartered in Sterling, Virginia, proudly serving healthcare facilities across the United States since its founding in 2010. As one of the nation's largest and fastest‑growing healthcare staffing firms in the nation, we staff thousands of nursing, allied health, locum tenens, pharmacy, therapy, direct‑hire, and non‑clinical professionals across hospitals, clinics, long‑term care facilities, labs and more. We're one of the most decorated staffing agencies in America-ranked a Top Travel Nursing Company by BluePipes, recognized among the fastest‑growing and most diverse staffing firms by Inc. 5000, Staffing Industry, WBJ and USPAACC-and remain deeply committed to excellence, inclusion, and community impact.

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