Revenue Integrity Leader at Option Care Health

Extraordinary Careers. Endless Possibilities.

With the nation’s largest home infusion provider, there is no limit to the growth of your career.

Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 6,000 team members including 2,900 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and employees.

As a two-year recipient of the Gallup Exceptional Workplace Award, we recognize that part of being extraordinary is building a thriving workforce that is as diverse as the patients and communities we serve.
Join a company that is taking action to develop a culture that is more inclusive, respectful, engaging and rewarding for all team members. We are committed to hiring, developing, and retaining a diverse workforce.

Job Description Summary:

As the Revenue Integrity Leader, you will be at the heart of ensuring that our ambulatory infusion clinic (AIC) operations are financially robust and compliant. You’ll lead the oversight of our entire revenue cycle process, from charge capture and coding to billing and collections. Your role will be crucial in optimizing revenue and ensuring that our Infusion Clinics can continue to provide exceptional care.

Job Description: ​

Job Responsibilities (listed in order of importance and/or time spent)

• Lead with Purpose. Oversee and enhance all revenue cycle capture and management activities for our Infusion Clinics, ensuring smooth and effective processes.
• Drive Excellence. Manage charge capture, coding, billing, claims submission, denial management, payment posting, and collections with precision and integrity. Develop and monitor metrics to ensure functions of revenue integrity team are performed efficiently and with a high degree of accuracy and customer service
• Innovate and Improve. Develop and implement standards of practice, policies and procedures to support and advance our revenue cycle management efforts.
• Strategic Insight. Prepare and analyze performance reports, including cash collections, claims rejections, and AR aging, to identify trends and opportunities for improvement, driving actionable insights for revenue growth and financial stability.
• Compliance Champion. Ensure adherence to state, federal, and payer-specific regulations, including HIPAA, coding, billing and collections regulations, safeguarding our operations and reputation.
• Empower Your Team. Build, mentor, and manage a high-performing team, providing training and development to keep them at the forefront of industry practices and driving high levels of team member engagement and empowerment across the organization.
• Collaborate and Coordinate. Act as a key liaison with payers, vendors, and internal teams, resolving issues and ensuring timely payments while promoting continuous process improvements.
• Enhance Systems. Work with IT to optimize systems for maximum efficiency in revenue cycle processes, and lead efforts to implement strategic objectives and budget oversight.
• Lead with Vision. Present updates and strategic recommendations to senior leadership, driving forward our mission with a clear vision and actionable insights designed to drive revenue growth and reduce financial risk.

Supervisory Responsibilities

Does this position have supervisory responsibilities?

(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)

No        

Yes       X 

Basic Education and/or Experience Requirements

• Bachelor’s degree or equivalent experience
• At least 8 years in healthcare finance, revenue cycle management, patient accounting and physician billing, coding and documentation, preferably in ambulatory infusion or specialty settings.
• Must be a Certified Coder with demonstrated experience in compliance.

Basic Qualifications

• Regulatory Knowledge. In-depth understanding of service line charge optimization, government and commercial payer regulations, and coding and billing rules including, but not limited to, experience with Medicare Part B “incident to” billing.  Demonstrated ability to understand and communicate complex issues and changes relating to regulatory compliance and disseminating information regarding government and third-party payer regulations and requirements.
• Technical Skills. Extensive knowledge of healthcare billing, coding (CPT, ICD-10), and Government and Commercial payer regulations.  This includes knowledge of charge creation, processing and reconciliation in a health care environment as well as experience with overseeing prospective and retrospective claim audits.
• Leadership Skills. Proven ability to manage teams and drive performance improvements, with a strong track record of clear communication and problem-solving. Ability to effectively communicate with provider and managerial staff at all levels.  Strong project management capabilities.

Physical Demand Requirements

Travel Requirements:  (if required)

Preferred Qualifications & Interests (PQIs)

This job description is to be used as a guide for accomplishing Company and department objectives, and only covers the primary functions and responsibilities of the position. It is in no way to be construed as an all-encompassing list of duties.

Due to state pay transparency laws, the full range for the position is below:

Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

Pay Range is $100,217.59-$167,029.32

Benefits:

-401k

-Dental Insurance

-Disability Insurance

-Health Insurance

-Life Insurance

-Paid Time off

-Vision Insurance

Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.

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