The Revenue Integrity Pharmacist will oversee the daily operations of the Pharmacy Financial Navigation Program and will work collaboratively with the pharmacy clinical and operational areas and the GHC Epic Willow team. In addition, this role is responsible for developing and sustaining communication with the Revenue Cycle, Patient Access, Patient Financial Services, Hospital Billing, Managed Care, and Health Information Management departments to ensure clarity, consistency and accuracy around the pharmacy charge, reimbursement and revenue cycle.

The Revenue Integrity Pharmacist will evaluate pharmacy claim denials, process discrepancies and identify areas for workflow improvement through routine data analysis using internal databases and key performance indicators. Best practices in pharmacy denials management will be identified and developed to ensure the department is fiscally responsible and compliant with all commercial, state and federal regulations.

The Revenue Integrity Pharmacist will provide regular updates to pharmacy and executive leadership through area assessments and compliance improvement recommendations. A summary of payor denials and recommendations will be presented to Pharmacy leadership and appropriate Chesapeake Regional Healthcare committees.