Director of Billing, Revenue Cycle Optimization

AmeriPharma

Director of Billing leading Revenue Cycle Management at AmeriPharma tasked with optimizing billing practices across Medical and Pharmacy Benefit platforms.

Posted 5/8/2026full-timeRemote • California • 🇺🇸 United StatesLead💰 $150,000 - $200,000 per yearWebsite

Tech Stack

Tools & technologies

Tableau

About the role

Key responsibilities & impact

Oversee and integrate billing operations for both Medical Benefit (J-Codes, HCPCS, CPT codes) and Pharmacy Benefit (NCPDP standards)
Design and execute "test billing" scenarios to identify new revenue streams
Apply deep knowledge of U.S. commercial payor policies to navigate complex Prior Authorization requirements
Collaborate with the Contracting team to ensure billing practices align with specific network rates
Audit existing RCM workflows to eliminate bottlenecks
Ensure all optimizations remain compliant with OIG, HIPAA, and CMS guidelines
Define and report on aggressive RCM metrics, including Days Sales Outstanding

Requirements

What you’ll need

Minimum 8–10 years of leadership in Specialty Pharmacy or Infusion RCM
Advanced expertise in Medical Benefit billing (CMS-1500/UB-04) and Pharmacy Benefit billing (NCPDP)
Comprehensive knowledge of national and regional commercial insurance reimbursement policies and "White Bagging/Brown Bagging" dynamics
Proficiency in data analytics tools (Excel, PowerBI, or Tableau)
Bachelor’s degree in finance or healthcare administration, or related field (Master’s or CPC/CPB certification preferred)

Benefits

Comp & perks

Performance Bonus (Quarterly/Annual)
Multi-factor scorecard designed to reward operational excellence and financial growth
Incentives for reducing Days Sales Outstanding below a specific target
Bonuses tied to keeping the initial denial rate below 5%

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

billing operationsMedical Benefit billingPharmacy Benefit billingPrior AuthorizationRCM workflowsdata analyticsrevenue cycle management metricsJ-CodesHCPCSCPT codes

Soft Skills

leadershipcollaborationauditingproblem-solvingcommunication

Certifications

CPCCPBBachelor’s degree in financeBachelor’s degree in healthcare administrationMaster’s degree