Hybrid Billing & Medical Operations Leader

Independent Health Association; Buffalo (NY); Hybrid; USD 77,000 - 95,000; Full time

Benefits offered by this job

Scorecard incentive

Full range of benefits

Generous paid time off

Hybrid work model

Job summary

Independent Health is seeking a Manager-Billing and Medical Operations to lead pharmacy and medical claims processing at Reliance Rx. You will supervise billing teams, monitor workflows, and drive timely reimbursements while ensuring regulatory and contractual compliance.

The role emphasizes leadership, process improvements, and collaboration with internal and external stakeholders to optimize revenue cycle performance.

Qualifications

• Bachelor's degree required; four years of experience may substitute for the degree.
• Five years of third party claims billing, patient collections, or high-volume pharmacy experience, including two years in specialty pharmacy.
• Two years of progressive leadership/management responsibility.
• Specialty pharmacy and copay assistance/billing preferred.
• Medical billing and 837 claim experience preferred.
• Strong leadership, coaching and mentoring skills with objective, timely issue resolution.
• Excellent written and verbal communication and problem‑solving skills.
• Strong organizational, process and time management skills with multi-tasking ability.
• Demonstrated alignment with Reliance values: Collaborative, Accessible, Results‑Oriented, Empowering, Supportive.

Responsibilities

• Oversee all NCPDP claims processing and medical claims submission (837, CMS1500).
• Train the team on differences between pharmacy vs medical benefits and claims types.
• Develop and promote best billing practices; perform root cause analysis on discrepancies.
• Maintain knowledge of regulatory requirements (Medicare/Medicaid) and monitor payor compliance.
• Lead the Billing Specialist team; manage productivity and performance metrics.
• Oversee AR, denial management, and aging; ensure timely payments and accuracy.
• Collaborate with Finance, Infusion, and Account Management to improve revenue cycle.
• Support process improvements and system enhancements for efficiency.

Skills

Leadership

Coaching

Communication

Time management

Problem solving

Mentoring

Education

Bachelor's degree

Tools

NCPDP system

Job description

Independent Health is seeking a Manager-Billing and Medical Operations to lead pharmacy and medical claims processing at Reliance Rx. You will supervise billing teams, monitor workflows, and drive timely reimbursements while ensuring regulatory and contractual compliance.

The role emphasizes leadership, process improvements, and collaboration with internal and external stakeholders to optimize revenue cycle performance.