Manage reimbursement activities for multiple infusion and specialty pharmacy business units, including referral intake, billing, and collections. Lead and mentor a team of up to 60 staff members while ensuring regulatory compliance and meeting financial performance metrics.
Process patient referrals by verifying benefits, obtaining prior authorizations, and ensuring accurate billing to reduce denial rates. Maintain detailed documentation of case activity and communicate effectively with franchise partners and payers to resolve outstanding claims.
The Revenue Cycle Manager oversees reimbursement activities including referral intake, authorizations, billing, and collections for multiple pharmacy business units. They are responsible for managing large teams, ensuring regulatory compliance, and meeting financial KPIs through effective coaching and process optimization.
Develop and implement strategic initiatives for Revenue Cycle Management with a focus on automation, systems, and operational efficiency. Monitor key performance indicators and ensure regulatory compliance across all revenue cycle policies and procedures.
Process medical claims for home infusion services while ensuring accuracy and timeliness to reduce denial rates. Maintain detailed documentation of case activity and communications within the CareTend system.
The Collections Associate manages insurance account inventories to resolve outstanding balances and ensure accurate revenue cycle operations. They perform claim follow-up, research denials, and collaborate with internal teams to maintain healthy accounts receivable.
The Solutions Architect will design and implement secure, scalable technology solutions that align with healthcare regulations and business objectives. They will lead the integration of AI, automation, and cloud-native architectures while collaborating with clinical and engineering teams to ensure operational excellence.
Provide strategic leadership and business coaching to franchise locations to optimize financial performance and ensure high-quality patient care. Lead strategic initiatives, manage operational compliance, and serve as the primary point of contact for franchise owners regarding standard operating procedures.
The Regional Business Coach provides strategic leadership and operational oversight to franchise locations to ensure high-quality patient care and financial performance. This includes driving brand integrity, managing strategic initiatives, and serving as the primary point of contact for franchise owners regarding standard operating procedures.
Collect outstanding patient accounts receivable and manage self-pay balances for franchise partners. This includes processing payments, setting up payment arrangements, and educating patients on out-of-pocket expenses.
Collect Home Infusion claims by reviewing outstanding balances and following up with insurers and patients to reduce denial rates and bad debt. Analyze denial trends to recommend process improvements and manage the appeals process for denied claims.
Process Home Infusion medical and pharmacy claims accurately to reduce denial rates and bad debt. Manage the revenue cycle by resolving rejected claims and documenting all account activity in CareTend.
Collect Home Infusion claims by reviewing outstanding balances, managing denials, and following up with insurers and patients. Analyze denial trends to recommend process improvements and ensure timely reimbursement while maintaining accurate account documentation.
The Intake Specialist processes referrals and manages medical billing to ensure accuracy and reduce denial rates. They also verify benefits, obtain prior authorizations, and maintain clear communication with patients regarding financial obligations.
