Revenue Cycle Analyst

Thrifty White Pharmacy•Maple Grove, MN

4h•$95,000 - $105,000•Hybrid

About The Position

The Revenue Cycle Analyst researches and analyzes data for revenue-generating lines of business, including third-party contract management, usual and customary (U&C) and retail pricing, discount cards, and 340B. The role uses SQL and Thrifty White technology to investigate and resolve underpayments and payment discrepancies and to develop insights and mitigation strategies. The analyst maintains professional relationships with third-party payers, hospital partners, and vendors. This position is based in Maple Grove, Minnesota, and reports to the corporate office two days per week; flexible work-from-home options are available.

Requirements

AAS degree or equivalent.
Two to three years of experience with data analytics.
Excellent verbal and written communication skills, including communication with customers, accounts receivable team members, internal and external partners, and leadership.
Exceptional follow-through to ensure work is completed correctly the first time.
Familiarity with pharmacy insurance processing, or the ability and willingness to quickly learn and apply the necessary knowledge.
Proficient computer skills, including Word, Excel, Outlook, and SQL.
Ability and desire to assess processes from a fresh perspective to drive improvements and efficiencies.
Ability to troubleshoot and problem-solve using available tools and resources before escalating issues.
Ability to complete projects quickly when requested by the Manager, Director, or executive leadership.
Ability to operate phones and copy, print, and scan machines.
Ability to prioritize, multitask, and manage workload.
Ability to maintain effective working relationships with third parties, partners, and leadership.
Ability to maintain confidentiality.
Must be able to have and maintain a clear record without exclusion, sanctions, or debarments with the Office of the Inspector General at hire and monthly thereafter.

Nice To Haves

Insurance and/or pharmacy experience.
Knowledge of PeopleSoft, Microsoft Office, TWRX, SQL, and OnBase.
If these qualifications are not already present, a drive and ability to quickly learn new things, especially in these areas.

Responsibilities

Provide the Manager or Director with data analysis and reporting on various lines of business.
Develop SQL-query reporting to identify potential payment errors and contractual payment discrepancies.
Work with third-party payers, including Optum, Caremark, and ESI, to research claims and address discrepancies.
Analyze GER, BER, and PLC charges and validate their accuracy.
Use technology to ensure claims are billed appropriately.
Review and report on reimbursement trends.
Create and maintain a third-party payor dashboard for executive review.
Review 340B accounts to identify missed opportunities and the need to recontract.
Review monthly 340B account budgets against actual results and provide analysis.
Manage relationships with 340B hospital partners and third-party administrators, including Macro Helix and Sentry.
Perform other job duties as assigned.