Pharmacy Claims Analyst

A company is looking for a Claims Analyst Pharmacy Revenue Cycle. Key Responsibilities Research, resolve, and prepare claims that have not passed payer edits and determine actions to resolve rejected drug claims Serve as a subject matter expert for provider relationships, service issues, reimbursement, and claims Monitor rejections on electronic and paper claims to identify necessary enhancements or fixes in system edits Required Qualifications Bachelor's degree in Business, Healthcare or a closely related field, or equivalent work experience Certified Pharmacy Technician preferred; Coding Certification CPC, RHIT preferred 1 to 3 years of experience in healthcare, coding, finance, revenue cycle, patient accounting, or physician billing Advanced working knowledge of professional billing flows and revenue cycle tasks Strong knowledge of claim edits, CPT/HCPCS, ICD-10-CM-PCS diagnosis codes, and drug NDC numbers

Jun 24, 2025 - 18:40

A company is looking for a Claims Analyst Pharmacy Revenue Cycle. Key Responsibilities Research, resolve, and prepare claims that have not passed payer edits and determine actions to resolve rejected drug claims Serve as a subject matter expert for provider relationships, service issues, reimbursement, and claims Monitor rejections on electronic and paper claims to identify necessary enhancements or fixes in system edits Required Qualifications Bachelor's degree in Business, Healthcare or a closely related field, or equivalent work experience Certified Pharmacy Technician preferred; Coding Certification CPC, RHIT preferred 1 to 3 years of experience in healthcare, coding, finance, revenue cycle, patient accounting, or physician billing Advanced working knowledge of professional billing flows and revenue cycle tasks Strong knowledge of claim edits, CPT/HCPCS, ICD-10-CM-PCS diagnosis codes, and drug NDC numbers