Head of Billing and Collections- Fuze Rx

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    "title": "Head of Billing and Collections- Fuze Rx",
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    "location": "Remote - California",
    "postedOn": "Posted 25 Days Ago",
    "timeType": "Full time",
    "startDate": "2026-05-12",
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    "jobDescription": "<div><div><div><div><div><div><div><h1><b>Job Summary</b><br /> </h1></div></div></div></div></div></div></div>About Fuze Health<br>At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare. We empower millions to digitally connect with care providers, essential health resources and needed treatments – and enable care providers, employers, health plans and life sciences companies to meaningfully enhance quality, outcomes and value. We are dedicated to helping our partners evolve and modernize to meet emerging patient and marketplace needs.<br><br>Fuze Health’s foundation is built upon the strategic combination of several proven, technology-powered innovators in the digital health, diagnostics, and pharmacy sectors. Our growing portfolio brings together the capabilities of industry leaders including LetsGetChecked, Truepill, and Alto Pharmacy, to create a distinctive, unified force in healthcare. Together, we have the shared vision, advanced capabilities and talented teams to deliver next-generation solutions that patients and healthcare partners need today and into the future.<h1><br /><br /><b>Job Description</b><br /> </h1><p><b><b>Job Description</b></b></p><p><span>The Head of Billing and Collections is responsible for overseeing the daily operations of the billing and collections department, ensuring accurate and timely submission of claims and invoices, managing revenue cycle processes, and leading a team to maximize collections. This leadership role focuses on reducing claim denials, managing payments per payer contracts, and optimizing cash collections in a high-volume setting. You will oversee a team of professionals dedicated to ensuring the efficient and effective delivery of patient support services and revenue cycle management. You will lead initiatives to optimize operations, drive continuous improvement, and ensure compliance with regulations while fostering a collaborative and high-performance environment.</span></p><p></p><p><b><span>Key Responsibilities</span></b></p><ul><li><p><span>Team Leadership &amp; Management: Supervises billing and AR staff, assigning daily work, training new employees, and mentoring team members on billing techniques.</span></p></li><li><p><span>Workflow Optimization: Develops and implements policies, procedures, and best practices to improve billing efficiency and revenue integrity.</span></p></li><li><p><span>AR Management &amp; Collections: Monitors AR aging reports to identify and resolve delinquent accounts, underpayments, and denials.</span></p></li><li><p><span>Claim Adjudication &amp; Appeals: Manages the resolution of rejected claims, submits appeals for denied claims, and reconciles pharmacy payments.</span></p></li><li><p><span>Compliance &amp; Auditing: Ensures compliance with HIPAA, state/federal regulations, and payer contracts (Medicare, Medicaid, commercial).</span></p></li><li><p><span>Reporting: Generates and analyzes financial reports, tracking key performance metrics for pharmacy leadership.</span></p></li><li><p><span>Communication: Serves as a liaison between the pharmacy staff, finance department, and insurance payers regarding billing issues. </span></p></li></ul><p></p><p><b><span>Key Performance Indicators (KPIs)</span></b></p><ul><li><p><span>Reduced Days Sales Outstanding (DSO) in Accounts Receivable.</span></p></li><li><p><span>High first-pass claim acceptance rates.</span></p></li><li><p><span>Minimal write-offs and bad debt.</span></p></li><li><p><span>Improved denial resolution turnaround time. </span></p></li></ul><p></p><p><b><span>Qualifications and Skills</span></b></p><ul><li><p><span>Experience: 10&#43; years overall billing, collection, and AR management, with 3 - 5&#43; years of experience in medical/pharmacy billing and team leadership.</span></p></li><li><p><span>Knowledge: Strong understanding of pharmacy adjudication systems and third-party payer rules.</span></p></li><li><p><span>Technical Skills: Proficiency in pharmacy management software, preferably Inmar, and Microsoft Excel.</span></p></li><li><p><span>Performance Management: Demonstrated track record of driving operational excellence and delivering high-quality results.</span></p></li><li><p><span>Soft Skills: Strong analytical, problem-solving, and communication skills, with the ability to lead in a fast-paced environment. </span></p></li></ul><p></p><p><b><span>Preferred Requirements</span></b></p><ul><li><p><span>Bachelor’s degree in Business, Finance, or Healthcare Administration or related field.</span></p></li><li><p><span>Experience with 340B claims management</span></p></li></ul><h1><br /><br /><b>Additional Information</b><br /> </h1><p></p><p><span>Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.</span></p><p></p><p><i>Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Fuze Health’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.</i></p><p></p><p></p><p>Salary Range<span>: $110,400-$138,000</span></p><p>Commission Eligible:<span> No</span></p><p>Travel<span>: No</span></p><p>Location Requirement: </p><ul><li><p>FuzeRx <span> is limited to individuals residing in the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington (WA), Wisconsin</span></p></li></ul><p></p><p>Employment Authorization Requirement: <span>Applicants must be authorized to work for any employer in the U.S. Alto Pharmacy, Fuze Health, LetsGetChecked, and Fuze Care Services can not take over, transfer, or sponsor any visa type at this time.</span></p><p></p><p>Benefits - Fuze Health <span>Full-time employee benefits include: dental, vision, and multiple group medical plans to choose from, a 401(k) retirement savings plan, group life insurance, accidental death and dismemberment (AD&amp;D) insurance, flexible spending account (FSA) and health savings account (HSA), commuter benefits, employer-paid short-term (STD) and long-term disability (LTD) insurance, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program). Employees are also provided flexible vacation time, accrued paid sick time, 10 paid holidays, (2 floating holidays for full time non-exempt employees) , and eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent, 4 weeks paid caregiver leave, and a Lifestyle Spending Account allowance each month.</span></p><p><span>More Benefits Information Here: </span><a href=\"https://west.acrisure.com/fuzehealth/benefits/\" target=\"_blank\"><u>Fuze Health Benefits Site </u></a></p><p></p><p><span>The application deadline is June 16, 2026. This application deadline may be extended based on business needs.</span></p><p></p><p><i>#LI-Remote </i></p><p><span style=\"color:#000000\"><i><b>Equal Opportunity Employer</b></i></span></p><p><span style=\"color:#000000\"><i>Fuze Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at </i></span><a target=\"_blank\" href=\"mailto:talent&#64;fuzehealth.com\"><span style=\"color:#1155cc\"><i><u>talent&#64;fuzehealth.com</u></i></span></a><span style=\"color:#000000\"><i>. </i></span></p><p><br /></p><p><span style=\"color:#000000\"><i>Fuze Health considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E-Verify participating company.</i></span></p><p><br /></p><p><span style=\"color:#000000\"><i><b>Use of Automated Decision Tools</b></i></span></p><p><span style=\"color:#000000\"><i>Fuze Health recruiters and hiring managers may use automated decision tools to help identify candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. Fuze Health does not use automated decision tools to make hiring decisions; hiring decisions always involve human review and input. If you have any questions or would like to request an alternative process, please contact us a</i></span><span style=\"color:#222222\"><span><i>t </i></span></span><span style=\"color:#1155cc\"><span><i>talent&#64;fuzehealth.com</i></span></span><span style=\"color:#222222\"><span><i>.</i></span></span><span style=\"color:#000000\"><i> </i></span></p><p><br /></p><p><span style=\"color:#000000\"><i><b>Privacy Notice</b></i></span></p><p><span style=\"color:#000000\"><i>To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our </i></span><a target=\"_blank\" href=\"https://www.fuzehealth.com/candidate-privacy-notice\"><span style=\"color:#1155cc\"><i><u>Privacy Notice for Job Applicants</u></i></span></a><span style=\"color:#000000\"><i>.</i></span></p>",
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