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.
Education and Experience
Minimum Required Education: Bachelor’s Degree in Pharmacy and 2 years pharmacist experience or a PharmD degree.
Preferred Education: PGY1 Pharmacy Practice Residency
Preferred Experience: Experience working in a hospital outpatient infusion center, home infusion, specialty pharmacy or managed care setting.
Demonstrated proficiency with EPIC Healthcare software.
Experience with Windows, Excel, PowerPoint, Business Objects, or other financial/analytical software
Certificates, Licenses, Registrations
Applicants must be licensed to work as a Pharmacist in the State of Virginia
Must maintain BLS certification
Internal Number: 9406
About Chesapeake Regional Medical Center
At Chesapeake Regional Medical Center, our employees are committed to improving the health of our community. Since opening in 1976, the hospital has grown with our community and added services to improve the health of residents in southeastern Virginia and northeastern North Carolina.
Chesapeake Regional Medical Center was the first hospital in the state to offer all private rooms. The hospital’s 350 beds are arranged in specialty units and are staffed by professional, caring nurses and clinical personnel. Our critical care units are among the most progressive, state-of-the-art facilities in the region. The Birthplace delivers more babies than any other community hospital in Hampton Roads. Our Emergency Dept is the busiest in the region and is a Certified Chest Pain Center and Stroke Center. More than 400 physicians have privileges at Chesapeake Regional Medical Center and represent nearly every medical specialty.
Our wages are competitive and our benefit package includes medical, dental and vision coverage; free life insurance, short-term and long term disability, pension plan and EAP; tuition assistance; Paid Annual Leave accrual; etc.