Team Lead - Pharmacy & Infusion

Overview

JOB TITLE: Team Lead - Pharmacy & Infusion

LOCATION: Remote

DURATION: Direct Hire

PAY RANGE: $28 - $33.65/hr

• Minimum of 2 years in home infusion billing or accounts receivable and 5 years in healthcare reimbursement roles, with strong knowledge of payer billing methodologies.
• At least 2 years of supervisory experience, including training, monitoring, and ensuring quality and accuracy of staff work.
• Proficiency with Microsoft Office (Excel/Word), Brightree system knowledge, and strong understanding of HIPAA regulations and financial reporting processes.

RCM Team Lead is responsible for staff’s financial results of all the insurance companies assigned to Brightree home infusion/pharmacy customers. In addition, this role is responsible for assisting the Director in creating SOPs for the team to follow, assisting the Director in creating procedures and systems for quality assurance as directed by Medicare, Medicaid, and private insurance. This role also assists in creating and revising standard operating procedures and educates partners, vendors, and internal teams on those procedures.

Responsible for training, monitoring quantity, and quality assurance of work performed by internal team members.

• Understand all general rules, guidelines, and methods to get paid from assigned payers and the ability to back up/fill in for staff when necessary.
• Responsible for the financial results of each Brightree RCM customer by ensuring accuracy of their team that results in:
  • Streamlining processes to reduce adjustments and write-offs.
  • Ensuring the billing methodology for each payer is documented and set up throughout the Brightree system to realize maximum reimbursement.
• Propose and implement changes and updates to the configuration in areas such as:
  • Price tables
  • Pharmacy contacts
  • Insurance settings
  • Therapy and per diems
  • Modules adoption
  • Additional services
• Identify areas of opportunity to better streamline internal or external processes by:
  • Making suggestions for system enhancements to the Brightree system.
  • Implementing process improvements to increase efficiency and accuracy.
• Prepare and submit reports to Director as needed, including but not limited to:
  • Quality Assurance Reporting
  • Denial Analyst Reporting
  • Service Level Agreement Reporting
  • Productivity and benchmark results
  • Monthly financial reporting
  • Other key reporting as identified by the Director or Brightree RCM Customer
• Ensure adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals.
• Maintain patient confidentiality and function within the guidelines of HIPAA.
• Train new employees on all Brightree RCM Policies & Procedures.
• Learn and document the billing methodology for new payer assignments for existing or new RCM accounts.
• Perform other tasks and responsibilities as assigned.

• High school diploma required.
• Minimum of 2 years of home infusion billing or accounts receivable experience required.
• Minimum of 2 years of experience working in & maintaining HIPAA standards.
• Highly skilled in using computers & Microsoft products (Excel and Word) is required.
• Minimum of 2 years of supervisory experience, preferably in home infusion.
• Math aptitude.
• Strong problem-solving skills focused on resolving complex home infusion claims.
• Effective communicator with strong oral, written, and persuasive skills and capability to deal with people at all levels in the organization and the public in a professional manner.
• Exceptional organizational skills with high attention to detail and the ability to multitask.
• Self-starter, results-driven, highly motivated, high energy.
• Proven track record of working towards and exceeding metrics strongly preferred.
• A 2-year degree or additional college coursework.
• 5 years of experience in a healthcare reimbursement role.

We are shaping the futurefuture, and we recognize the need to build on and broaden our existing skills and continue to attract and retain the world’s best talent. We offer:

• Holistic benefits packages
• Flexible work arrangements
• Workforce culture that allows employees to grow personally and professionally
• Competitive salaries

• Comprehensive medical, vision, dental, and life insurance
• AD&D, short-term and long-term disability insurance
• Sleep care management
• Health Savings Account (HSA)
• Flexible Spending Account (FSA)
• Commuter benefits
• 401(k)
• Employee Stock Purchase Plan (ESPP)
• Employee Assistance Program (EAP)
• Tuition assistance
• 15 days Paid Time Off (PTO) in the first year
• 11 paid holidays + 3 floating days
• 14 weeks primary caregiver or 2 weeks secondary caregiver leave for new family members

BENEFITS

SUMMARY:

Individual compensation is determined by skills, qualifications, experience, and location. Compensation details listed in this posting reflect the base hourly rate or annual salary only, unless otherwise stated. In addition to base compensation, full-time roles are eligible for Medical, Dental, Vision,…