Pharmacy Business Analyst - FT - Days - Memorial Specialty Pharmacy jobs in United States
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Memorial Healthcare System · 16 hours ago

Pharmacy Business Analyst - FT - Days - Memorial Specialty Pharmacy

positionMiramar, FL
timeFull-time
remoteOnsite
senioritySenior Level
date5+ years exp

Memorial Healthcare System (MHS) is a nationally recognized leader in providing patient care and safety. They are seeking a Pharmacy Business Analyst to review, analyze, and coordinate financial transactions and ensure compliance with billing requirements for pharmacy and medical billing claims.

Health Care
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H1B Sponsor Likelynote

Responsibilities

Prepares financial and operational reports as needed
Ensure compliance and conducts audits of Pharmacy NCPDP claims and Medical Billing
Provides expert knowledge of billing for a variety of self pay and health insurance plans, including Medicare, Managed Care, and private insurance
Refers accounts for patient assistance and drug replacement when needed
Assist in maintaining records needed for business needs, including NCPDP, and license updates, HIN, etc
Investigates and responds to third party audits to minimize third party chargebacks
When needed reconciles charge backs as a results of payer audits
Audits and analyzes reimbursement opportunities for patient and third party accounts
Audits and reconciles accounts receivables and payments from payers
Reviews, addresses and reconciles profitability opportunities by reviewing appropriateness of payments vs. cost of goods
Ensures pharmacy billing compliance with current regulatory guidelines, insurance billing requirements, state and federal laws and regulations ( Including bit not limited to Medicare part B and D claims)
Develops process to ensure collection when applicable

Qualification

Medical billingPharmacy billing complianceFinancial analysisCertified Coding AssociateRegistered Pharmacy TechnicianCustomer serviceEffective communicationProblem solving

Required

High School Diploma or Equivalent (Required)
Certified Coding Associate (CCA) - American Health Information Management Association (AHIMA)
Registered Pharmacy Technician (RPT LICENSE) - State of Florida (FL)
Five (5) years of experience in retail, specialty pharmacy or home infusion pharmacy medical/pharmacy billing

Preferred

Medical billing and coding certification
Licensed/Registered in the State of Florida

Company

Memorial Healthcare System

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Be at the heart of exceptional care.
dateFounded in 1953
location
Easton, Maryland, USA
people-size10001+ employees
web-link
http://www.memorialregional.com

H1B Sponsorship

Memorial Healthcare System has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (7)
2024 (15)
2023 (4)
2022 (3)
2021 (4)
2020 (4)

Funding

Current Stage
Late Stage

Leadership Team

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Paul Gaden
Chief Executive Officer, Memorial Regional Hospital
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Rita Bunch
Chief Operating Officer, Memorial Regional Hospital
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Recent News

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Memorial Foundation and Joe DiMaggio Children’s Hospital Foundation Present $15 Million for Pediatric, Maternity and Cancer Initiatives
2025-09-25
Sun Sentinel
New birth center unveiled at Memorial Regional Hospital
2025-02-06
PRWeb
A Labor of Love: Memorial Regional Hospital Unveils $68 Million Expansion and Renovation of Family Birthplace, Elevating Maternity Care in South Florida
2025-01-30
Company data provided by crunchbase