Intake Manager - RCM

RiseMe; Philadelphia (Philadelphia County); On-site; USD 65,000 - 81,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

PTO and holidays

Paid paternal leave

401(k) matching

Tuition reimbursement

Employee assistance programs

Job summary

Vital Care Infusion Services is seeking a Reimbursement Lead to manage reimbursement activities across infusion and specialty pharmacy units. You will oversee referral intake, authorizations, billing, and collections, while delivering exceptional service to franchise partners, payers, and patients.

Ideal candidates bring 5+ years in home infusion reimbursement, 5+ years of management, and a Bachelor’s degree or equivalent. This role is full-time and remote with nationwide scope.

Qualifications

• Bachelor’s degree or equivalent work experience preferred.
• Minimum 3-5 years of home infusion therapy experience required.
• Minimum 5 years of management experience.

Responsibilities

• Manage multiple teams in processing new patient referrals, insurance benefit investigation, prior authorizations, billing, and collections. Up to 60 people.
• Track workload distribution and conduct ongoing needs assessments to identify staffing opportunities.
• Meet and exceed financial and department KPIs through targeted initiatives.
• Provide coaching and mentoring to Supervisors and conduct annual performance reviews.
• Monitor payroll for accuracy and timely processing.
• Act as escalation point for supervisors and patients to resolve issues.
• Develop and maintain Standard Operating Procedures for responsibilities.
• Foster a customer-service culture through training and mentoring.
• Audit transactions to ensure policy compliance and identify training needs.
• Recruit and onboard staff to build a high-performing team.

Skills

Leadership

Team management

Coaching

Customer service

Regulatory compliance

Education

Bachelor’s degree or equivalent

Job description

Recognized as a “Best Place to Work Modern Healthcare” – Join a team where people come first.

At Vital Care, we are committed to creating an inclusive, growth-focused environment where every voice matters. Vital Care (www.vitalcare.com) is the premier pharmacy franchise business with franchises serving a wide range of patients, including those with chronic and acute conditions. Since 1986, our passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States. We have over 100 franchised Infusion pharmacies and clinics in 35 states, focusing on the underserved and secondary markets. We know infusion services, and we guide owners along the path of launch, growth, and successful business operations.

What we offer:

• Comprehensive medical, dental, and vision plans, plus flexible spending, and health savings accounts.
• Paid time off, personal days, and company-paid holidays.
• Paid Paternal Leave.
• Volunteerism Days off.
• Income protection programs include company-sponsored basic life insurance and long-term disability insurance, as well as employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
• 401(k) matching and tuition reimbursement.
• Employee assistance programs include mental health, financial and legal.
• Rewards programs offered by our medical carrier.
• Professional development and growth opportunities.
• Employee Referral Program.

Job Summary:

Perform functions to manage the reimbursement activities of multiple infusion and specialty pharmacy business units, focusing on referral intake, authorizations, billing, and collections, depending on the area of responsibility. Will cultivate an environment of outstanding customer service in all interactions with franchise partners, payers, and patients. Includes developing a highly effective team to meet the critical challenges of timely, successful reimbursement from payers. Focusing on regulatory compliance as a foundation of all revenue cycle policies and procedures. Perform functions to manage the reimbursement activities of multiple infusion and specialty pharmacy business units, focusing on referral intake, authorizations, billing, and collections, depending on the area of responsibility. Will cultivate an environment of outstanding customer service in all interactions with franchise partners, payers, and patients. Includes developing a highly effective team to meet the critical challenges of timely, successful reimbursement from payers. Focusing on regulatory compliance as a foundation of all revenue cycle policies and procedures.

Duties/Responsibilities:

• Manage multiple teams in processing new patient referrals, insurance benefit investigation, prior authorizations, billing, and collections depending on area of responsibility. Up to 60 people.
• Manage resource allocations to meet KPIs. Track workload distribution and conduct ongoing needs assessments to identify staffing opportunities.
• High degree of focus on meeting and exceeding financial and department metrics.
• Conduct 1:1 coaching and mentoring with Supervisors to create a highly effective Team. In addition to annual performance reviews. Provide counseling when required to address performance.
• Monitor payroll for accuracy to ensure proper processing.
• Serve as escalation agent for supervisors and team to resolve complaints from franchise partners or patients.
• Create, implement, communicate, and maintain Standard Operating Procedures covering functional areas of responsibilities.
• Cultivate an environment of customer service through training, feedback, and staff mentoring.
• Audit transactions processed by the team to ensure accuracy and compliance with policies and procedures to identify training opportunities.
• Interview and select staff to meet business requirements and create a highly effective Team.
• Perform other related duties as assigned.

Education and Experience:

• Bachelor’s degree or equivalent work experience preferred.
• Minimum 3-5 years of home infusion therapy experience required.
• Minimum 5 years of Management experience.

Physical Requirements:

• Sitting: Prolonged periods of sitting are typical, often for the majority of the workday.
• Keyboarding: Frequent use of a keyboard for typing and data entry.
• Reaching: Occasionally reaching for items such as files, documents, or office supplies.
• Fine Motor Skills: Precise movements of the fingers and hands for tasks like typing, using a mouse, and handling paperwork
• Visual Acuity: Good vision for reading documents, computer screens, and other detailed work.

Be part of an organization that invests in you!

Vital Care Infusion Services is an equal-opportunity employer and values diversity at our company. We do not discriminate on the basis of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans’ status, or any other basis protected by applicable federal, state, or local law. Vital Care is a U.S.-based employer and hires only individuals who are authorized to work in the United States and who perform their work from within the United States. Applicants and employees must accurately disclose their current work location and work authorization status during the application and hiring process. Any material misrepresentation or omission regarding identity, location, work authorization, qualifications, or other employment-related information may result in withdrawal of a job offer, immediate termination of employment, and pursuit of any remedies available under applicable law.

Vital Care Infusion Services participates in E-Verify. This position is full-time and remote.The salary range for this position is $64,766 - $80,957.