About River’s Edge Pharmacy:
River’s Edge Pharmacy has become a leader in infusion therapy services. Administered by specially trained infusion nurses, these services are provided at standalone locations, physicians’ offices. Each location provides individualized care in a private setting for procedures including IVIG, Hemophilia, Chemotherapy, TPN, and Pain Management.


The River's Edge Story:
River’s Edge Pharmacy started in Rancho Mirage, CA in 2008 to address the need for compassionate care by specialty pharmacies. In 2013, the Company moved to a larger facility in Palm Desert, CA.

The successful execution of River’s Edge Pharmacy’s growth strategy led to the opening of a total of nine infusion locations and two pharmacies in California.


Since the expansion, River’s Edge Pharmacy has become the specialty pharmacy and infusion service provider of choice for patients and physicians seeking exceptional expertise, human kindness, and professional guidance.

The team of pharmacists, technicians, and care experts at River’s Edge Pharmacy serve as patient advocates by combining professional expertise with caring support. These services are all part of River’s Edge Pharmacy’s commitment to helping patients live better lives while navigating the complicated world of medicine and health insurance.

Position Overview:
Oversees reimbursement within the pharmacy & infusion centers operations departments, providing leadership to the departments while managing processes, productivity, and financial performance for the assigned area. Key responsibilities include intake, billing, collections, cash posting, and benefit verifications. Develops and implements revenue cycle strategies and intake protocols to achieve goals related to new referrals, accounts receivable, bad debt, and cash flow. Ensures financial targets are met and aligned with organizational objectives.

  • Directly manages the billing and collections team, overseeing day-to-day operations in the revenue cycle center.
  • Reviews new referrals to ensure profitability, verifying patient eligibility and obtaining authorizations based on payor standards.
  • Maximizes reimbursement by ensuring timely and accurate claims submission and payment per contracted rates.
  • Monitors reimbursement activity, providing trend reports and assessments to senior management.
  • Tracks key performance indicators in reimbursement, working with supervisors to improve service levels, cash flow, reduce DSO, and minimize bad debt.
  • Ensures compliance with company, Medicare, Medicaid, and payor guidelines, performing audits as needed.
  • Anticipates and communicates legislative and regulatory changes impacting billing policies.
  • Completes required projects and reports on a daily, weekly, or monthly basis as directed by the COO.
  • Audit all billing and collections KPIs to ensure proper accuracy and within expected timelines
  • Fosters a positive work environment, building morale, motivation, and teamwork.
  • Develops, coaches, and manages staff through training, setting objectives, and performance feedback.

Plus – may perform other duties as assigned.

Education:

  • Bachelor’s degree in Business Administration or Health Care informatics preferred.

Experience:

  • Bachelor’s degree and at least 4 years of healthcare reimbursement/billing experience OR a high school diploma and at least 7 years of healthcare reimbursement/billing experience
  • At least 2 years of experience directly managing people including hiring, developing, motivating, and directing people as they work
  • Experience in identifying operational issues and recommending and implementing strategies to resolve problems

Supervision and Management Responsibilities:

  • Lead and oversee the corporate billing and reimbursement department, including the management of aging components, billings, cash receipts, and funding services.

Working Conditions:

  • Standard office environment.
  • Occasional travel within Southern California may be required.
  • Full-time position with standard business hours; flexibility to work additional hours during peak periods is expected.

Confidential Information:

This position has access to confidential information such as patient information and company information.

Compensation:

Pay range (DOE): $90,000 - $115,000 / year

Actual base pay could vary based on factors including but not limited to experience, subject matter expertise, geographic location where work will be performed, and the applicant's skill set. The base pay is just one component of the total compensation package for employees. Other rewards may include an annual cash bonus and a comprehensive benefits package.

Benefits:

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life insurance
  • Flexible spending account
  • Health savings account
  • 401(k) matching
  • Employee Assistance Program
  • Paid sick time
  • Paid time off
  • Wellness program
  • Education program

Equal Opportunity Employer:
We are an equal opportunity employer committed to diversity and inclusion. We celebrate diversity and are dedicated to fostering an inclusive environment for all employees