Hybrid/Remote Revenue Cycle Leader (Specialty Pharmacy)

Heritage Specialty Pharmacy; Lincoln (NE); Hybrid; USD 95,000 - 130,000; Full time

Job summary

Heritage Specialty Pharmacy seeks an experienced Revenue Cycle Manager to lead Admissions and Billing teams and oversee the full patient revenue cycle from referral through reimbursement. The role focuses on optimizing patient access, improving financial performance, and ensuring compliance across specialty pharmacy revenue cycle functions.

You will drive process improvements, collaborate with cross-functional teams, monitor KPIs, and serve as escalation point for complex payer issues.

Qualifications

• Bachelor's degree in Healthcare Administration, Finance, Accounting, or related field.
• 7+ years of leadership experience in healthcare billing, reimbursement, revenue cycle, or specialty pharmacy operations.
• Strong understanding of specialty pharmacy revenue cycle processes and payer requirements.
• Experience managing teams, performance metrics, and operational improvement initiatives.
• Excellent communication, problem-solving, and relationship-building skills.

Responsibilities

• Lead the Admissions and Billing teams, providing coaching, accountability, and professional development.
• Oversee referral intake, benefits investigations, prior authorizations, patient financial clearance, billing, collections, and reimbursement activities.
• Monitor and improve KPIs such as cash collections, accounts receivable, claim denials, authorization turnaround times, referral conversion, and reimbursement outcomes.
• Collaborate with pharmacy, clinical, compliance, IT, accounting, and patient experience teams to improve workflows and patient access to therapy.
• Serve as an escalation point for complex payer, provider, patient, and reimbursement issues.
• Drive process improvements, standardization, and automation initiatives that enhance operational and financial performance.
• Ensure compliance with payer, regulatory, accreditation, and organizational requirements.

Skills

Leadership experience

Communication skills

Problem-solving

Relationship-building

Education

Bachelor's degree in Healthcare Administration, Finance, Accounting, or related field

Job description

Heritage Specialty Pharmacy seeks an experienced Revenue Cycle Manager to lead Admissions and Billing teams and oversee the full patient revenue cycle from referral through reimbursement. The role focuses on optimizing patient access, improving financial performance, and ensuring compliance across specialty pharmacy revenue cycle functions.

You will drive process improvements, collaborate with cross-functional teams, monitor KPIs, and serve as escalation point for complex payer issues.