Supervisor, Credit & Collections

• Lead the establishment maintenance and optimization of Electronic Remittance Advice (ERA/835) and Electronic Funds Transfer (EFT) processes with third-party payers.
• Oversee new store implementation activities ensuring timely setup of payer portals Medicaid and Medicare access dispensing system permissions reconciliation services and required file integrations.
• Partner with insurance carriers third-party payers and reconciliation vendors to resolve missing remittance information and payment issues.
• Conduct detailed accounts receivable reviews at the claim level identifying researching and resolving outstanding balances using third-party AR platforms.
• Perform liability reviews and resolve open liabilities through effective analysis and follow-through.
• Investigate payment discrepancies identify root causes and implement corrective actions to improve reimbursement accuracy.
• Resolve approved deductions through appropriate adjustment entries and manage unauthorized deductions in accordance with established procedures.
• Convert paper Explanation of Benefits (EOB) documentation into electronic formats for upload and reconciliation within AR systems.
• Develop maintain and analyze reports dashboards and spreadsheets to monitor performance and identify trends.
• Support continuous process improvement initiatives that enhance reimbursement outcomes operational efficiency and team effectiveness.
• Stay current on healthcare reimbursement regulations pharmacy billing requirements and industry best practices through ongoing professional development and training.
• Ensure strict adherence to HIPAA requirements company policies and regulatory standards regarding confidentiality and data privacy.

Who You Are

Minimum Qualifications

• High school diploma or GED equivalent.
• 1 year of experience in Accounts Receivable medical billing healthcare reimbursement or a related revenue cycle function.
• Experience working with financial applications databases spreadsheets and word processing software.
• Working knowledge of claims processing payer reimbursement practices and healthcare revenue cycle operations.
• Strong analytical and problem-solving skills with the ability to investigate and resolve complex discrepancies.
• Effective verbal and written communication skills including the ability to professionally interact with payers vendors customers and internal stakeholders.
• Strong attention to detail with demonstrated ability to manage multiple priorities in a fast-paced environment.
• Intermediate Microsoft Excel and data entry skills.
• Ability to maintain confidentiality and comply with HIPAA and regulatory requirements.

Preferred Qualifications

• Experience within the pharmacy specialty pharmacy or healthcare services industry.
• Knowledge of electronic remittance advice (835) EFT enrollment processes and payer portal administration.
• Experience with accounts receivable reconciliation claims management and payment posting systems.
• Familiarity with Medicaid Medicare and commercial payer reimbursement processes.
• Associates degree or additional healthcare revenue cycle certification or equivalent experience.

Collaborate

• Build strong partnerships with payers reconciliation vendors pharmacy operations teams and internal stakeholders to improve reimbursement performance.
• Share knowledge and best practices that strengthen team effectiveness and operational consistency.

Inspire

• Foster a customer-focused and solutions-oriented approach when addressing payer and reimbursement challenges.
• Support team success by providing guidance communication and positive influence across departments.

Develop

• Pursue continuous learning in healthcare reimbursement pharmacy billing and revenue cycle management.
• Encourage process improvements that increase accuracy efficiency and service quality.

Execute

• Prioritize competing responsibilities while maintaining exceptional accuracy and attention to detail.
• Take ownership of claim resolution store implementation activities and reimbursement outcomes.

Impact

• Drive measurable improvements in collections performance reimbursement accuracy and operational efficiency.
• Identify opportunities to streamline workflows and enhance the overall payer management process.

• Model a Growth Mindset by embracing continuous learning seeking feedback and adapting to change.
• Act as a Talent Activator by coaching team members supporting development and fostering an inclusive high-performing environment.
• Be an Impact Maker by driving accountability achieving operational goals and improving business results.
• Lead as a Change Champion by promoting innovation process improvements and organizational adaptability.