Senior Reimbursement Analyst

Beth Israel Lahey Health • Westwood, MA

4d • $72,000 - $96,000

About The Position

The Pharmacy Revenue Cycle Analyst supports the financial performance of a large health system pharmacy enterprise under the direction of the Revenue Cycle Manager-Pharmacy. The role analyzes reimbursement, billing, revenue cycle operations, and payer performance across specialty pharmacy, infusion, retail, and provider-administered drug services. It partners with Pharmacy Operations, Finance, Revenue Cycle, and Information Systems teams to optimize reimbursement, ensure revenue integrity, and identify revenue enhancement opportunities.

Requirements

• Bachelor's degree in Finance, Business, Healthcare Administration, Pharmacy Administration, or a related field.
• 3+ years of healthcare revenue cycle, pharmacy finance, specialty pharmacy, infusion reimbursement, or healthcare analytics experience.
• Advanced Excel and data analytics skills, with the ability to translate complex data into actionable insights.
• Strong analytical, organizational, problem-solving, and project management skills.
• Demonstrated ability to manage multiple priorities while maintaining attention to detail and accuracy.
• Must be vaccinated against influenza as a condition of employment.

Responsibilities

• Analyze pharmacy reimbursement, denials, underpayments, and accounts receivable trends to identify revenue recovery and optimization opportunities.
• Perform analytics, rebate reconciliation, dispute management, and financial performance reporting.
• Analyze 340B and MFP rebate eligibility, reimbursement, and payment variances within pharmacy systems; prepare and submit appeals and disputes to manufacturers, payers, and third-party administrators to ensure accurate rebate capture and revenue recovery.
• Investigate payer denials and underpayments, prepare appeals, and coordinate resolution with payers and internal stakeholders.
• Support medication charge capture, reimbursement integrity, and pharmacy revenue cycle process improvements.
• Develop dashboards and reports tracking reimbursement performance, denials, rebates, payer trends, and key pharmacy financial indicators.
• Collaborate with pharmacy leadership, finance, contracting, and revenue cycle teams to improve operational and financial outcomes.
• Stay current on pharmacy reimbursement regulations, payer policies, 340B requirements, and Medicare reimbursement changes.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior