Pharmacy Business Office Manager

Mountain Area Health Education Center - MAHEC•Asheville, NC

32d•Onsite

About The Position

The Pharmacy Business Office Manager oversees the financial, administrative, and operational functions that support pharmacy revenue cycle performance. This role is responsible for reconciling pharmacy payments, monitoring third‑party payer activity, ensuring accurate claim data, reconciling rebates, and supporting compliance with billing and reimbursement requirements. The manager partners closely with the Administrative Director, Finance Team, and Central Business Office to develop efficient workflows, maintain high-quality data, and ensure timely and accurate financial processes. This role description is a general description of the essential job functions. It is not intended to describe all the duties the Business Office Manager may perform.

Requirements

At least 5 years of experience in healthcare revenue cycle, pharmacy billing, pharmacy reimbursement, or financial reconciliation.
Demonstrated competency in payment posting, payer processes, and reconciliation workflows.
Excellent skills in Microsoft Office including Word, Excel, PowerPoint, and database applications required.
Communication Skills
Decision Making
HealthCare Knowledge
Interpersonal Skills
Organizational Values
Problem Solving

Nice To Haves

Bachelor’s degree in Finance, Accounting, Business Administration, Healthcare Administration, or related field.
Knowledge of 340B drug pricing program.

Responsibilities

Manages and oversees pharmacy payment reconciliation processes, including third-party payer payments, cash posting, remittance review, and variance resolution.
Ensures timely and accurate reconciliation of claims, reimbursements, and adjustments.
Identifies payer trends, denials, and payment discrepancies; partners with the pharmacy team to resolve issues.
Ensures clean, accurate claim, collection, and demographic data supporting pharmacy billing workflows.
Assists in analyzing current costs, revenues, financial commitments, and obligations incurred to predict future revenues and expenses.
Monitors contract pharmacy performance, payment trends, reconciliation timelines, and fee structures; escalates concerns related to revenue leakage, incorrect fees, or missed opportunities.
Supports optimization of 340B revenue through identification of process gaps, payer or prescriber issues, or data mismatches that affect savings capture.
Develops and reports pharmacy-specific KPIs (e.g., payment accuracy, reconciliation timelines, denial trends).
Evaluates processes and makes recommendations on changes to enhance quality and efficiency.
Evaluates and improves workflows to enhance efficiency, accuracy, and compliance.
Assists in the development and maintenance of policies, procedures, and training materials related to pharmacy revenue cycle, billing workflows, reconciliation, and payer compliance.
Audits and reports monthly pharmacy business KPIs, including reconciliation accuracy, claim volume, payment timelines, and exception trends.
Orients all new staff to MAHEC’s clinical policies and procedures.
Collaborates regularly with pharmacy leadership, CBO, finance, and compliance teams to improve efficiency and ensure alignment
Maintains understanding of current 340B regulations, manufacturer restrictions, HRSA guidance, and payer carve‑out requirements; updates internal processes and communicates changes to pharmacy team.