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Senior Project Coordinator, Pharmacy Reimbursement
University Hospitals. Coordinate review and resolution of medication-related billing denials .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medication reimbursement processes, denial trend analysis, and project management within a healthcare setting. Proficient in data analysis, regulatory compliance, and effective communication across interdisciplinary teams.
Highest-signal resume keywords
HOPD Billing KnowledgeMedication Reimbursement ProcessesProject Management ExperienceData Analysis ProficiencyRegulatory Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data AnalysisProcess Improvement InitiativesDocumentation OptimizationCoding ComplianceQuality Measurement Management
Soft Skills
Excellent Problem-Solving SkillsStrong Organizational SkillsEffective Communication SkillsInterpersonal SkillsMentorship Ability
Tools & Technologies
MS Office ProductsData Reporting Tools
Industry Keywords
Healthcare AdministrationRevenue CyclePrecertificationProtected Health Information (PHI)IRB Approval
About the role
Key responsibilities & impact- Coordinate review and resolution of medication-related billing denials
- Analyze denial trends, identify root causes, and develop data-driven denial-reduction recommendations
- Support HOPD medication reimbursement and denial prevention initiatives
- Partner with Pharmacy Services, Revenue Cycle, and Precertification teams
- Lead development and implementation of proactive medical necessity review services
- Optimize documentation, coding, and payer compliance
- Manage quality measurement and improvement projects
- Assist in developing project methodologies and managing project and implementation-plan components
- Coordinate regulatory matters, write protocols, create operations manuals, and lead data collection
- Facilitate projects across University Hospitals departments
- Provide project-status communications to leadership
- Coordinate primary data collection and oversee compilation and analysis of secondary datasets
- Support projects requiring interdepartmental and external resources
- Manage and report project timelines and deadlines
- Manage engagements with external customers and health-system-related vendors
- Coordinate activities with UHHS colleagues and project collaborators
- Provide leadership, mentorship, and education to team members
- Perform other duties as assigned
- Comply with policies, standards, and PHI requirements
Requirements
What you’ll need- Bachelor's Degree in business, finance, healthcare administration, or similar field (Required)
- 5+ years of experience in a healthcare setting (Required)
- Experience working in a fast-paced environment and adapting to changing priorities on a deadline (Required)
- Project management experience (Preferred)
- Knowledge of HOPD billing, medication reimbursement processes, medical necessity criteria, and payer authorization guidelines
- Experience analyzing denial trends, identifying root causes, and implementing process improvement initiatives that improve reimbursement outcomes and reduce denials
- Experience working collaboratively with pharmacy, revenue cycle, finance, patient access, precertification, and clinical teams
- Proficiency in data analysis and reporting tools, with the ability to translate complex data into actionable recommendations
- Strong organizational skills and ability to prioritize competing demands and work independently in a fast-paced healthcare environment
- Demonstrated ability to achieve results independently and as part of a team
- Excellent problem-solving and decision-making skills
- Excellent writing ability and communication skills
- Advanced computer skills, including MS Office products and internet applications
- Regulatory experience achieving IRB approval for studies
- Excellent interpersonal skills and ability to work with individuals at all levels of an organization
- Ability to safely and securely maintain Protected Health Information (PHI)
- Ability to travel locally to UH sites (5% local travel; posting also states 10% travel)
Benefits
Comp & perks- Full-time schedule
- Regular employee status
- Hybrid work arrangement
- Day shift
- Local travel to UH sites