Strategic Revenue Cycle Lead - Specialty Pharmacy

Heritage Biologics, LLC; Lee's Summit (MO); On-site; USD 95,000 - 140,000; Full time

Job summary

Heritage Specialty Pharmacy is seeking an experienced Revenue Cycle Manager to lead our Admissions and Billing teams and oversee the full patient revenue cycle from referral through reimbursement. This role is responsible for optimizing patient access, improving financial performance, enhancing operational efficiency, and ensuring compliance across revenue cycle functions.

We are looking for a leader who can drive improvements across payer processes, ensure timely reimbursements, and collaborate

Qualifications

• 7+ years of leadership experience in healthcare billing, reimbursement, revenue cycle, or specialty pharmacy operations.
• Strong understanding of specialty pharmacy and/or infusion revenue cycle processes, payer requirements, prior authorizations, and reimbursement.
• 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 key performance indicators 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

Revenue cycle

Payer requirements

Team management

Communication

Education

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

Job description

Heritage Specialty Pharmacy is seeking an experienced Revenue Cycle Manager to lead our Admissions and Billing teams and oversee the full patient revenue cycle from referral through reimbursement. This role is responsible for optimizing patient access, improving financial performance, enhancing operational efficiency, and ensuring compliance across revenue cycle functions.

We are looking for a leader who can drive improvements across payer processes, ensure timely reimbursements, and collaborate