Supervisor, Claims - Remote

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

The Revenue Cycle Supervisor is responsible for overseeing the day-to-day operations of the revenue cycle function, ensuring timely and accurate claim processing, compliance, and resolution of escalations. This role provides leadership and direction to revenue cycle staff, supporting performance through training, development, and process improvement initiatives. The Supervisor will play a key role in analyzing claims data, implementing efficiencies, and ensuring adherence to applicable state and federal regulations. This position requires a deep understanding of pharmacy revenue cycle workflows, strong problem-solving skills, and the ability to lead a team in a dynamic healthcare environment.

Responsibilities

• Assumes responsibility for directing all day-to-day activities related to revenue cycle objectives.

• Provides leadership and direction to revenue cycle staff to meet or exceed business improvement.

• Analyze and trend claims related data to identify inefficiencies and implement process.

• Lead work groups with the ability to identify problems and propose systematic solutions and develop/maintain necessary work plans.

• Maintain designated standards established for handling incoming work with applicable state and federal laws.

• Maintains compliance accountability specific to claims administrations in accordance training, and appropriate resources.

• Supervises and directs staff, supporting professional growth by providing education.

• Provide leadership and direction through developing and updating policy and procedures, programs, determining appropriate standards and procedures, determining staffing requirements, and training opportunities.

• Recruit and discharge employees when necessary.

Skills & Abilities

• Knowledge of Specialty/Home Infusion software

• Knowledge of pharmacy revenue cycle workflows

• Medical terminology, ICD-10, and HCPCS coding required

• Must have strengths in methods and techniques of business process automation

• Proficient knowledge in MS Office and PC skills preferred

• Able to demonstrate excellent organizational, interpersonal, and communication skills.

• Maintain designated production and quality standards required. 

• Must have the ability to effectively interact with internal and external customers.

• Ability to react to users' needs in a timely and efficient manner and direct staff with minimal amount of supervision. 

Requirements

• Bachelor's Degree preferred or equivalent business experience of two (2) years. 

• Two (2) years minimum management experience required.

CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.