Senior Billing & Medical Operations Leader

Independent Health; 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

Job summary

Independent Health in Williamsville, NY is seeking a Manager-Billing and Medical Operations to supervise pharmacy and medical claims processing for Reliance Rx. You will lead billing teams, ensure timely submissions, maintain compliance, and drive revenue-cycle improvements.

The role requires a Bachelor’s degree with significant experience in 3rd party billing, 837 processing, and leadership. Hybrid onsite work at Williamsville with comprehensive benefits and growth opportunities.

Qualifications

• Bachelor’s degree required; four additional years of experience may substitute.
• Five years of experience with third party claims billing and high-volume pharmacy, including two years in specialty areas.
• Two years of progressive leadership/management responsibility.
• Specialty pharmacy and copay assistance billing experience preferred.
• Medical billing and 837 claim transaction experience preferred.
• Strong leadership and communication with ability to coach and mentor billing staff.

Responsibilities

• Oversee all NCPDP claims processing and medical claims submission via 837 and CMS-1500.
• Train team on billing differences between pharmacy and medical benefits.
• Develop and implement best billing practices; address escalated issues and perform root-cause analyses.
• Maintain regulatory knowledge for billing (Medicare/Medicaid) and ensure payor compliance.
• Manage Billing Specialist team and monitor productivity and performance metrics.
• Oversee accounts receivable workflow from submission to denial resolution; monitor reimbursement trends.

Skills

Leadership

Communication

Problem-solving

Time management

Mentoring

Cross-functional collaboration

Education

Bachelor’s degree

Tools

NCPDP systems

837/CMS-1500 processing

Job description

Independent Health in Williamsville, NY is seeking a Manager-Billing and Medical Operations to supervise pharmacy and medical claims processing for Reliance Rx. You will lead billing teams, ensure timely submissions, maintain compliance, and drive revenue-cycle improvements.

The role requires a Bachelor’s degree with significant experience in 3rd party billing, 837 processing, and leadership. Hybrid onsite work at Williamsville with comprehensive benefits and growth opportunities.