Role Description
As an AR Supervisor, Credit & Collections, you will play a critical leadership role in optimizing revenue cycle processes, strengthening payer relationships, and ensuring accurate reimbursement for pharmacy services. This opportunity combines team leadership, process improvement, analytics, and cross-functional collaboration, allowing you to make a meaningful impact while growing your expertise in healthcare reimbursement and accounts receivable operations.
What You'll Do
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Lead key payer-facing accounts receivable processes while supporting the success of the SPS Collections team.
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Drive operational excellence across payer collections, remittance processing, and reimbursement workflows to improve cash flow, reduce outstanding receivables, and support successful onboarding of new pharmacy locations.
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Lead the establishment, maintenance, and optimization of Electronic Remittance Advice (ERA/835) and Electronic Funds Transfer (EFT) processes with third-party payers.
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Oversee new store implementation activities, ensuring timely setup of payer portals, Medicaid and Medicare access, dispensing system permissions, reconciliation services, and required file integrations.
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Partner with insurance carriers, third-party payers, and reconciliation vendors to resolve missing remittance information and payment issues.
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Conduct detailed accounts receivable reviews at the claim level, identifying, researching, and resolving outstanding balances using third-party AR platforms.
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Perform liability reviews and resolve open liabilities through effective analysis and follow-through.
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Investigate payment discrepancies, identify root causes, and implement corrective actions to improve reimbursement accuracy.
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Resolve approved deductions through appropriate adjustment entries and manage unauthorized deductions in accordance with established procedures.
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Convert paper Explanation of Benefits (EOB) documentation into electronic formats for upload and reconciliation within AR systems.
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Develop, maintain, and analyze reports, dashboards, and spreadsheets to monitor performance and identify trends.
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Support continuous process improvement initiatives that enhance reimbursement outcomes, operational efficiency, and team effectiveness.
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Stay current on healthcare reimbursement regulations, pharmacy billing requirements, and industry best practices through ongoing professional development and training.
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Ensure strict adherence to HIPAA requirements, company policies, and regulatory standards regarding confidentiality and data privacy.
Qualifications
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High school diploma or GED equivalent.
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1+ year of experience in Accounts Receivable, medical billing, healthcare reimbursement, or a related revenue cycle function.
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Experience working with financial applications, databases, spreadsheets, and word processing software.
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Working knowledge of claims processing, payer reimbursement practices, and healthcare revenue cycle operations.
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Strong analytical and problem-solving skills with the ability to investigate and resolve complex discrepancies.
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Effective verbal and written communication skills, including the ability to professionally interact with payers, vendors, customers, and internal stakeholders.
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Strong attention to detail with demonstrated ability to manage multiple priorities in a fast-paced environment.
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Intermediate Microsoft Excel and data entry skills.
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Ability to maintain confidentiality and comply with HIPAA and regulatory requirements.
Preferred Qualifications
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Experience within the pharmacy, specialty pharmacy, or healthcare services industry.
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Knowledge of electronic remittance advice (835), EFT enrollment processes, and payer portal administration.
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Experience with accounts receivable reconciliation, claims management, and payment posting systems.
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Familiarity with Medicaid, Medicare, and commercial payer reimbursement processes.
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Associate's degree or additional healthcare revenue cycle certification, or equivalent experience.
Leadership Imperatives
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Model a Growth Mindset by embracing continuous learning, seeking feedback, and adapting to change.
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Act as a Talent Activator by coaching team members, supporting development, and fostering an inclusive, high-performing environment.
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Be an Impact Maker by driving accountability, achieving operational goals, and improving business results.
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Lead as a Change Champion by promoting innovation, process improvements, and organizational adaptability.