Supervisor, Credit & Collections

• Lead the establishment, maintenance, and optimization of Electronic Remittance Advice (ERA/835) and Electronic Funds Transfer (EFT) processes with third-party payers.
• Oversee new store implementation activities, ensuring timely setup of payer portals, Medicaid and Medicare access, dispensing system permissions, reconciliation services, and required file integrations.
• Partner with insurance carriers, third-party payers, and reconciliation vendors to resolve missing remittance information and payment issues.
• Conduct detailed accounts receivable reviews at the claim level, identifying, researching, and resolving outstanding balances using third-party AR platforms.
• Perform liability reviews and resolve open liabilities through effective analysis and follow-through.
• Investigate payment discrepancies, identify root causes, and implement corrective actions to improve reimbursement accuracy.
• Resolve approved deductions through appropriate adjustment entries and manage unauthorized deductions in accordance with established procedures.
• Convert paper Explanation of Benefits (EOB) documentation into electronic formats for upload and reconciliation within AR systems.
• Develop, maintain, and analyze reports, dashboards, and spreadsheets to monitor performance and identify trends.
• Support continuous process improvement initiatives that enhance reimbursement outcomes, operational efficiency, and team effectiveness.
• Stay current on healthcare reimbursement regulations, pharmacy billing requirements, and industry best practices through ongoing professional development and training.
• Ensure strict adherence to HIPAA requirements, company policies, and regulatory standards regarding confidentiality and data privacy.

Who You Are

Minimum Qualifications

• High school diploma or GED equivalent.
• 1+ year of experience in Accounts Receivable, medical billing, healthcare reimbursement, or a related revenue cycle function.
• Experience working with financial applications, databases, spreadsheets, and word processing software.
• Working knowledge of claims processing, payer reimbursement practices, and healthcare revenue cycle operations.
• Strong analytical and problem-solving skills with the ability to investigate and resolve complex discrepancies.
• Effective verbal and written communication skills, including the ability to professionally interact with payers, vendors, customers, and internal stakeholders.
• Strong attention to detail with demonstrated ability to manage multiple priorities in a fast-paced environment.
• Intermediate Microsoft Excel and data entry skills.
• Ability to maintain confidentiality and comply with HIPAA and regulatory requirements.

Preferred Qualifications

• Experience within the pharmacy, specialty pharmacy, or healthcare services industry.
• Knowledge of electronic remittance advice (835), EFT enrollment processes, and payer portal administration.
• Experience with accounts receivable reconciliation, claims management, and payment posting systems.
• Familiarity with Medicaid, Medicare, and commercial payer reimbursement processes.
• Associate's degree or additional healthcare revenue cycle certification, or equivalent experience.

Collaborate

• Build strong partnerships with payers, reconciliation vendors, pharmacy operations teams, and internal stakeholders to improve reimbursement performance.
• Share knowledge and best practices that strengthen team effectiveness and operational consistency.

Inspire

• Foster a customer-focused and solutions-oriented approach when addressing payer and reimbursement challenges.
• Support team success by providing guidance, communication, and positive influence across departments.

Develop

• Pursue continuous learning in healthcare reimbursement, pharmacy billing, and revenue cycle management.
• Encourage process improvements that increase accuracy, efficiency, and service quality.

Execute

• Prioritize competing responsibilities while maintaining exceptional accuracy and attention to detail.
• Take ownership of claim resolution, store implementation activities, and reimbursement outcomes.

Impact

• Drive measurable improvements in collections performance, reimbursement accuracy, and operational efficiency.
• Identify opportunities to streamline workflows and enhance the overall payer management process.

• Model a Growth Mindset by embracing continuous learning, seeking feedback, and adapting to change.
• Act as a Talent Activator by coaching team members, supporting development, and fostering an inclusive, high-performing environment.
• Be an Impact Maker by driving accountability, achieving operational goals, and improving business results.
• Lead as a Change Champion by promoting innovation, process improvements, and organizational adaptability.