Home Infusion Pharmacy Billing Supervisor
Position Summary
The Home Infusion Pharmacy Billing Supervisor is responsible for leading and managing billing operations for home infusion services, including medications, supplies, and nursing care. This role ensures accurate and timely claim submissions, insurance verification, and payment reconciliation. The supervisor oversees a team of billing professionals, maintains compliance with healthcare regulations, and drives continuous improvement in revenue cycle processes.
Key Responsibilities
- Supervise daily billing and collections activities to ensure timely and accurate invoicing for all home infusion services.
- Oversee the preparation and submission of insurance claims, verify patient benefits and payer contracts, and manage follow-up on denied or unpaid claims.
- Ensure billing codes, documentation, and reimbursement amounts are accurate and compliant with current healthcare regulations and payer guidelines.
- Recruit, train, mentor, and evaluate billing staff to foster a high-performing, collaborative team environment.
- Act as a subject matter expert to resolve complex billing discrepancies and account issues.
- Conduct regular audits to identify trends, inefficiencies, and opportunities for process optimization.
- Track billing and collection metrics, reconcile payments, and support financial reporting to maintain healthy cash flow.
- Collaborate with insurance providers, patients, and internal departments to resolve coverage issues and clarify billing details.
Required Qualifications
Bachelor's degree in Healthcare Administration, preferred-not requiredProfessional certifications such as Certified Professional Biller (CPB), Certified Coding Specialist (CCS), or Certified Revenue Cycle Professional (CRCP) are highly desirable.Minimum of 57 years of progressive experience in medical billing, with at least 3 years in a supervisory or leadership role.Prior experience in home infusion pharmacy billing or specialty pharmacy is strongly preferred.Proficiency in billing software (e.g., CPR+, Brightree, or similar platforms).Strong understanding of HCPCS, CPT, ICD-10 coding, and payer-specific billing requirements.Proven ability to lead and develop teams, manage performance, and foster accountability.Excellent interpersonal, written, and verbal communication skills.Strong analytical mindset with the ability to interpret data, identify trends, and implement solutions.Exceptional attention to detail and organizational skills to manage multiple priorities effectively.In-depth knowledge of healthcare billing regulations, HIPAA, and payer compliance standards.Preferred Qualifications
Experience with Medicare, Medicaid, and commercial insurance billing for infusion services.Familiarity with URAC, ACHC, or other accreditation standards related to home infusion.Intermediate Excel skills and experience with data analysis or dashboard reporting.Family Makes Us Stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.
We are eager to connect with you! Apply Now to get started at PruittHealth!
As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.