Perform functions to manage the reimbursement activities of multiple infusion and specialty pharmacy business units, focusing on referral intake, authorizations, billing, and collections, depending on area of responsibility. Will cultivate an environment of outstanding customer service in all interactions with franchise partners, payers, and patients. Includes developing a highly effective team to meet the critical challenges of timely, successful reimbursement from payers. Focusing on regulatory compliance as a foundation of all revenue cycle policies and procedures.
- Supervise team in processing new patient referrals, insurance benefit investigation, prior authorizations, billing, and collections depending on area of responsibility. Up to 30 people.
- Manage Team schedules to reallocate resources to meet KPIs. Track distribution of workloads and conduct ongoing needs assessments to identify staffing opportunities.
- Conduct 1:1 coaching, mentoring, feedback with Team Members, and annual performance reviews. Provide counseling when required to address performance.
- Monitor staff timecards for accuracy and ensure approval is timely for payroll.
- Serve as escalation agent for the team to resolve any franchise partner or patient complaints.
- Implement, communicate, and maintain operating procedures covering functional areas, quality, compliance, and related productivity expectations.
- Cultivate an environment of customer service through training, feedback, and staff mentoring.
- Audit transactions the team processes to ensure accurate processing and compliance with policies and procedures to identify training opportunities.
- Interview, select, and train staff to meet business requirements and create a highly effective Team.
- Perform other related duties as assigned.
- Highly effective communicator with superior listening, understanding, speaking, and writing skills.
- Solid business knowledge and ability to analyze data to identify actions to be taken.
- Lead by example and strong team-building skills, with the ability to influence, lead, teach, train, counsel, and coach to accomplish organizational goals.
- Ability to identify training requirements and develop and implement training models to improve results.
- Strong customer service and leadership skills to develop a customer-centric culture for the patients.
- Ability to work collaboratively across functional teams and manage projects.
- Analytical skills and business acumen demonstrated through proven problem-solving and the ability to exercise solid professional judgment in analyzing business issues and exploring options for resolution.
- Bachelor’s degree or equivalent work experience preferred.
- Minimum 3-5 years of home infusion therapy experience required.
- Minimum 3 years of supervisory experience