RCM Supervisor - Billing

Join Vital Care

At Vital Care, we are committed to creating an inclusive, growth-focused environment where every voice matters. Vital Care is the premier pharmacy franchise business with franchises serving a wide range of patients, including those with chronic and acute conditions. Since 1986, our passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States.

We have over 100 franchised Infusion pharmacies and clinics in 35 states, focusing on the underserved and secondary markets. We know infusion services, and we guide owners along the path of launch, growth, and successful business operations.

What We Offer:

• Comprehensive medical, dental, and vision plans, plus flexible spending, and health savings accounts.
• Paid time off, personal days, and company-paid holidays.
• Paid Paternal Leave.
• Volunteerism Days off.
• Income protection programs include company-sponsored basic life insurance and long-term disability insurance, as well as employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
• 401(k) matching and tuition reimbursement.
• Employee assistance programs include mental health, financial and legal.
• Rewards programs offered by our medical carrier.
• Professional development and growth opportunities.
• Employee Referral Program.

Job Summary

Perform functions to plan for and manage the Specialist positions, involving initial intake, billing, and collections requirements. Will cultivate an environment of outstanding customer service as the company's voice in all interactions with franchise partners, payers, and patients.

Duties/Responsibilities

• Supervise team in processing new patient referrals, insurance benefits investigation and verifications, prior authorizations, billing, and collections.
• Manage Reimbursement Specialist schedules to reallocate resources to meet KPIs. Track workload distribution and conduct ongoing needs assessments to identify staffing opportunities.
• Serve as an 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 performance expectations.
• Monitor team results to evaluate compliance with quality and productivity expectations and identify improvement opportunities.
• Collaborate with Payor/Benefit support programs to resolve missing claims reports and handle member escalations.
• Implement customer service standards of excellence and ensure compliance. Cultivate an environment of customer service orientation through training and mentoring staff in customer service and collection techniques.
• May be responsible for reconciling reimbursement checks against claims with some programs.
• Monitor team activities and work with Reimbursement Specialist to provide guidance, training, and improved skills in patient insurance billing, collections, benefit investigation, and insurance authorizations. Balance workload and manage schedules to suit demand and service standards.
• Audit transactions processed by the team to ensure accounts are accurate and appropriately escalated in compliance with policies and procedures and identify training opportunities. Review claims acceptance and rejection reports and perform necessary activities to correct and resubmit rejections.
• Interview, select, train, and assign department associates. Provide direction and mentoring. Develop and communicate performance metrics to assess the team's effectiveness, both individually and as a department.
• Evaluate performance and provide counseling, cross-training, and coaching to associates. Maintain mutually respectful employer relations.
• Perform other related duties as assigned.

Required Skills/Abilities

• 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.
• Demonstrated knowledge of current pharmacy applications and MS Office software, including strong Excel proficiency.
• Strong customer service and leadership skills to develop a customer-centric culture and instill ownership of the customer/patient experience. Ability to foster care and compassion for the patients while instilling price to exceed performance objectives.
• 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.

Education and Experience

• Bachelor's degree in business or equivalent work experience preferred.
• 2-3 years of experience is required in an infusion setting.
• Minimum 3 years of supervisor experience required.
• Knowledge of all Vital Care systems, including CareTend, and the RCM Portal.
• Knowledge of Payer Compliance.

Physical Requirements

• Sitting: Prolonged periods of sitting are typical, often for the majority of the workday.
• Keyboarding: Frequent use of a keyboard for typing and data entry.
• Reaching: Occasionally reaching for items such as files, documents, or office supplies.
• Fine Motor Skills: Precise movements of the fingers and hands for tasks like typing, using a mouse, and handling paperwork.
• Visual Acuity: Good vision for reading documents, computer screens, and other detailed work.

Be part of an organization that invests in you! We are reviewing applications for this role and will contact qualified candidates for interviews. Vital Care Infusion Services is an equal-opportunity employer and values diversity at our company. We do not discriminate on the basis of color, race, sex, age, religion, national origin, disability, gender identity, sexual orientation, veterans' status, or any other basis protected by applicable federal, state, or local law.

Vital Care Infusion Services