The Director of Patient Services – Infusion and Specialty Pharmacy is responsible for leading patient services which includes patient management, reauthorizations, and documentation across our existing patients who are on service. This role requires strong communication skills, attention to detail, and expertise in Medicare, Medicaid, Medical, Commercial, and PBM claims. Familiarity with CPR+ and CareTend is a plus. The ideal candidate will drive process improvements to optimize billing timelines, cash collections, and DSO as well as proactively ensure that disruption to ongoing care for patients is minimized resulting from insurance, physician, medication or other changes, while empowering teams to deliver exceptional service to both internal and external stakeholders.

Reports to: VP of Reimbursement – RCM

Job Type: Full-Time, Exempt

• Bachelor’s degree in business administration or communication, or related field
• 2+ years of experience in Billing and Collections
• 2+ years of Management experience
• Strong understanding of benefits/authorization and billing of Infusion
• Strong knowledge of Managed Care contracts
• Previous experience reimbursement billing and collections and customer service in a similar referral source-based setting is strongly preferred
• Must have strong PC skills, especially the MS Office suite. Previous experience with the pharmacy order processing system CPR+ billing software experience is a major advantage (although training will be provided)
• A strong work ethic and desire to serve our Reimbursement Team is required
• A strong desire and ability to take care of claims issues while following company procedures is required

Job Responsibilities, included but not limited to:

• Keep abreast of insurance coverage guidelines and infusion reimbursement terms for the vast array of insurances on the market
• Assume direct management over Reauthorization, Patient Management and Document Management
• Maintain knowledge of reimbursement principles
• Consistently works toward becoming a subject matter expert relative to Medicare, Medicaid and insurance company requirements for home infusion services
• Results oriented in achieving assigned cash collection and DSO goals
• Communicate effectively and express ideas clearly
• Prepare department reports to serve as resource both for the VP of Reimbursement and VP of Intake and update them as needed
• Maintain confidentiality of company and patient information
• Always maintains courteous demeanor
• Work effectively and maintains expected productivity
• Take all data and present to decision makers when identifying areas of improvement
• Maintains knowledge of, and compliance to all applicable laws, regulations, and SOPs always
• Provide effective employee training
• Management & Adaptability
• Provide employees targeted feedback
• Call center environment, managing large team of 25+ employees
• Ensure development of Staff is ongoing

Physical Demands 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and listen. Requires the ability to lift files, open filing cabinets and bend or stand as necessary. This position requires the ability to occasionally lift office products and supplies of 20 pounds but no more than 50 pounds.

Benefits & Perks:

• Comprehensive Medical, Dental, and Vision Package
• 401(k) Plan with Company Match
• Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays
• Life Insurance: Standard coverage with optional enhancements
• Employee Assistance Program: Free counseling and coaching sessions
• Emotional Well-being and Work-Life Balance Resources
• Short & Long-Term Disability: Company-paid with optional supplements
• Accidental Death and Dismemberment Insurance
• FSA and HSA: Manage healthcare expenses
• Commuter Spending Programs
• Volunteer and Engagement Opportunities
• Exclusive Discounts on entertainment, travel and various other supplemental and cellphone plans

Equal Employment Opportunity 

The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.