Head of Billing and Collections
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Job Description
Head of Billing and Collections at Fuze Health overseeing billing, collections, and revenue cycle management. Leading a team to enhance operational efficiency and compliance in a fast-paced healthcare environment.
Responsibilities:
- Overseeing the daily operations of the billing and collections department
- Ensuring accurate and timely submission of claims and invoices
- Managing revenue cycle processes
- Leading a team to maximize collections
- Focusing on reducing claim denials and managing payments per payer contracts
- Optimizing cash collections in a high-volume setting
- Supervising billing and AR staff, assigning daily work, training new employees, and mentoring team members on billing techniques
- Developing and implementing policies, procedures, and best practices to improve billing efficiency and revenue integrity
- Monitoring AR aging reports to identify and resolve delinquent accounts, underpayments, and denials
- Managing the resolution of rejected claims, submits appeals for denied claims, and reconciling pharmacy payments
- Ensuring compliance with HIPAA, state/federal regulations, and payer contracts
- Generating and analyzing financial reports, tracking key performance metrics for pharmacy leadership
- Serving as a liaison between the pharmacy staff, finance department, and insurance payers regarding billing issues
Requirements:
- 8+ years overall billing, collection, and AR management
- Strong understanding of the revenue cycle from billing through collections
- Proficiency in various billing softwares and strong Microsoft Excel
- Demonstrated track record of driving operational excellence and delivering high-quality results
- Strong analytical, problem-solving, and communication skills, with the ability to lead in a fast-paced environment
- Bachelor’s degree in Business, Finance, or Healthcare Administration or related field (preferred)
- 3+ years of experience in medical/pharmacy billing and team leadership (preferred)
- Experience with pharmacy adjudication systems and third-party payer rules is a plus (preferred)
Benefits:
- dental, vision, and multiple group medical plans to choose from
- a 401(k) retirement savings plan
- group life insurance
- accidental death and dismemberment (AD&D) insurance
- flexible spending account (FSA) and health savings account (HSA)
- commuter benefits
- employer-paid short-term (STD) and long-term disability (LTD) insurance
- additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program)
- flexible vacation time
- accrued paid sick time
- 10 paid holidays, (2 floating holidays for full time non-exempt employees)
- eight weeks of paid parental leave for eligible employees
- additional paid weeks for the birthing parent
- 4 weeks paid caregiver leave
- a Lifestyle Spending Account allowance each month
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