Job Summary

Job Description

The Head of Billing and Collections is responsible for overseeing the daily operations of the billing and collections department, ensuring accurate and timely submission of claims and invoices, managing revenue cycle processes, and leading a team to maximize collections. This leadership role focuses on reducing claim denials, managing payments per payer contracts, and optimizing cash collections in a high-volume setting. You will oversee a team of professionals dedicated to ensuring the efficient and effective delivery of patient support services and revenue cycle management. You will lead initiatives to optimize operations, drive continuous improvement, and ensure compliance with regulations while fostering a collaborative and high-performance environment.

Key Responsibilities

Team Leadership & Management: Supervises billing and AR staff, assigning daily work, training new employees, and mentoring team members on billing techniques.
Workflow Optimization: Develops and implements policies, procedures, and best practices to improve billing efficiency and revenue integrity.
AR Management & Collections: Monitors AR aging reports to identify and resolve delinquent accounts, underpayments, and denials.
Claim Adjudication & Appeals: Manages the resolution of rejected claims, submits appeals for denied claims, and reconciles pharmacy payments.
Compliance & Auditing: Ensures compliance with HIPAA, state/federal regulations, and payer contracts (Medicare, Medicaid, commercial).
Reporting: Generates and analyzes financial reports, tracking key performance metrics for pharmacy leadership.
Communication: Serves as a liaison between the 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

Experience: 10+ years overall billing, collection, and AR management, with 3 - 5+ years of experience in medical/pharmacy billing and team leadership.
Knowledge: Strong understanding of pharmacy adjudication systems and third-party payer rules.
Technical Skills: Proficiency in pharmacy management software, preferably Inmar, and Microsoft Excel.
Performance Management: Demonstrated track record of driving operational excellence and delivering high-quality results.
Soft Skills: 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

Additional Information

Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.

Salary Range: $110,400-$138,000

Commission Eligible: No

Travel: No

Location Requirement:

FuzeRx is limited to individuals residing in the following 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

Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S. Alto Pharmacy, Fuze Health, LetsGetChecked, and Fuze Care Services can not take over, transfer, or sponsor any visa type at this time.

Benefits - Fuze Health Full-time employee benefits include: 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, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program). Employees are also provided flexible vacation time, accrued paid sick time, 10 paid holidays, (2 floating holidays for full time non-exempt employees) , and eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent, 4 weeks paid caregiver leave, and a Lifestyle Spending Account allowance each month.

More Benefits Information Here: Fuze Health Benefits Site

The application deadline is June 16, 2026. This application deadline may be extended based on business needs.

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