Head of Billing and Collections- Fuze Rx

Job Summary Fuze Health is a digital health company dedicated to improving patient care through technology. Key Responsibilities Supervises billing and AR staff, assigning daily work, training new employees, and mentoring team members on billing techniques. Develops and implements policies, procedures, and best practices to improve billing efficiency and revenue integrity. Monitors AR aging reports to identify and resolve delinquent accounts, underpayments, and denials. Manages the resolution of rejected claims, submits appeals for denied claims, and reconciles pharmacy payments. Ensures compliance with HIPAA, state/federal regulations, and payer contracts (Medicare, Medicaid, commercial). Generates and analyzes financial reports, tracking key performance metrics for pharmacy leadership. Serves as a liaison between pharmacy staff, finance department, and insurance payers regarding billing issues. Key Performance Indicators (KPIs) Reduced Days Sales Outstanding (DSO) in Accounts Receivable. High first-pass claim acceptance rates. Minimal write-offs and bad debt. Improved denial resolution turnaround time. Qualifications and Skills 10+ years overall billing, collection, and AR management, with 3-5+ years of experience in medical/pharmacy billing and team leadership. Strong understanding of pharmacy adjudication systems and third-party payer rules. Proficiency in pharmacy management software, preferably Inmar, and 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. Preferred Requirements Bachelor’s degree in Business, Finance, or Healthcare Administration or related field. Experience with 340B claims management. Physical Requirements The role requires work at a computer terminal, stooping, bending, reaching for equipment and supplies, frequent repetitive motions, lifting, carrying, pushing, pulling, and moving light objects up to 20 pounds. Effective communication through verbal interactions, discern auditory information, and visual perception to perform essential job functions. Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, Fuze Health provides reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions unless undue hardship. Compensation Salary Range: $110,400 - $138,000. Commission Eligible: No. Location and Travel No travel required. Remote opportunities available for candidates residing in specified states. Eligible states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington (WA), Wisconsin. Benefits Dental, vision, and multiple group medical plans; 401(k); group life insurance; AD&D; FSA and HSA; commuter benefits; employer-paid STD and LTD; supplemental insurance plans including spouse life, legal, employee assistance, home health testing kits, fertility medication discount program; flexible vacation time; paid sick time; 10 paid holidays; floating holidays; 8 weeks paid parental leave for eligible employees; extra paid weeks for birthing parent; 4 weeks paid caregiver leave; monthly Lifestyle Spending Account allowance. Equal Opportunity Employer Fuze Health is an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. Reasonable accommodation available for applicants with disabilities. Contact View email address on click.appcast.io for accommodation. Additional Employment Information Fuze Health participates in E-Verify. Fuze Health also considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law. #J-18808-Ljbffr Alto Pharmacy