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Pharmacy Revenue Cycle Analyst

MedStar Health
United States, Maryland, Elkridge
Jul 07, 2025
General Summary of Position We are actively recruiting for an experienced Pharmacy Revenue Cycle Analyst to join our system Pharmacy team at MedStar Health. This role is responsible for Hospital Pharmacy billing practices at MedStar and supports ambulatory medication billing practices. Key to this role is investigation and resolution of billing issues and coordination with the Department of Pharmacy, Information Services, Rates and Reimbursement and Patient Financial Services at MedStar. Serves as a resource for pharmacy and ambulatory areas to optimize reimbursement for medications used in these areas and ensure that decisions and systems comply with regulatory requirements. Primary Duties and Responsibilities Conducts quality reviews to ensure that pharmacy charge description master (CDM) additions, inactivations, changes, and revisions are accurately completed in the clinical systems and coordinated with the financial systems. Monitors and analyzes billing issues, collaborating with others to identify and rectify the root causes of errors. Works closely with Revenue Cycle teams, Clinic Practice Managers, Pharmacy Directors, hospital informatics, and IS teams to resolve medication billing concerns. Collaborates with pharmacy staff, IT, and finance to develop processes and systems that ensure accurate and compliant charges. Coordinates with the hospital procurement team and ambulatory practice managers to ensure precise assignment of drug codes (NDC codes) to each medication in the chargemaster, in accordance with industry standards. Verifies and adjusts medication pricing based on drug acquisition costs, insurance contracts, and hospital and ambulatory policies. Partners with the Rates and Reimbursement team to conduct annual hospital pharmacy cost reviews. Engages in educating other healthcare professionals regarding the appropriate use and billing of medications Remains informed about national standards, regulations, and trends for medication revenue cycle. Ensures chargemaster data complies with federal and state guidelines for medication charging across MedStar, including hospitals and ambulatory clinics. Collaborates with pharmacists and 340b managers at each hospital to promptly address any discrepancies in medication charges. Generates reports on pharmacy charge trends and conducts regular audits. Analyzes data to identify potential areas for cost optimization and revenue improvement Utilizes all organizational resources effectively and efficiently. Minimum Qualifications Education Bachelor's degree Business or Computer Science required Experience 5 years of related pharmacy hospital billing practices and charge master experience preferred Licenses and Certifications ASHP Pharmacy Revenue Cycle Management Certificate required within 180 Days Knowledge, Skills, and Abilities Knowledge Microsoft Office suite, Advanced Excel and spreadsheet skills Proficiency in chargemaster systems and data analysis tools Ability to meticulously review and verify complex data to ensure accuracy Knowledge of healthcare billing regulations and compliance standards for hospitals and ambulatory clinics. Strong problem-solving skills to identify issues, develop solutions, and implement corrective actions Deep understanding of pharmaceutical terminology, drug classifications, and medication administration practices HIPAA policies on Confidentiality This position has a hiring range of $28.2 - $47.3