Manager, Billing – Operations

Independent Health

. Supervise and manage all pharmacy and medical claims processing .

Posted 10/19/2026full-timeBuffalo • New York • United StatesMid-LevelSenior💰 $76,500 - $95,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in pharmacy and medical claims processing, including NCPDP and 837 claims management, while optimizing revenue cycle performance and ensuring compliance with regulatory standards. Proven leadership in managing billing teams and resolving complex billing issues through effective communication and problem-solving.

Highest-signal resume keywords

Pharmacy Claims ProcessingMedical Billing837 Claim Transaction ExperienceLeadership and Team ManagementRevenue Cycle Optimization

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingBilling AuditsRoot Cause AnalysisDenial ResolutionProcess ImprovementPatient CollectionsSpecialty Pharmacy BillingCopay Assistance BillingQuality Assurance AuditsPerformance Metrics Monitoring

Soft Skills

Leadership SkillsCoaching and MentoringWritten and Verbal CommunicationProblem-SolvingOrganizational Skills

Industry Keywords

NCPDP Claims837 FilesCMS1500 ClaimsRegulatory ComplianceService-Level AgreementsBilling SpecialistsPatient Accounts ReceivableInfusion ServicesStrategic Business DevelopmentHigh-Volume Pharmacy

About the role

Key responsibilities & impact

Supervise and manage all pharmacy and medical claims processing
Manage billing and medical operations teams
Monitor daily workflow and phone metrics and complete daily billing queue audits
Assess claims processing system upgrades and enhancements and ensure best business practices
Oversee pharmacy NCPDP claims and medical claims processing, including 837 setup
Work with payors on 837 file development, claim submission, denials correction and resubmission, and payment accuracy
Optimize revenue cycle performance and resolve complex billing issues
Oversee NCPDP claims, 837 and CMS1500 medical claims, copay assistance billing, and paper claims
Train teams on pharmacy versus medical benefits and claims
Review escalated billing issues, perform root cause analysis, and provide follow-up, retraining, and disciplinary action when needed
Resolve claim rejections and identify overpayments, underpayments, and reimbursement discrepancies
Monitor regulatory and payor compliance, service-level agreements, and shipping timelines
Manage and develop Billing Specialists and monitor productivity and performance metrics
Oversee patient and insurance accounts receivable, denial resolution, and aging balances
Implement corrective action plans and oversee quality assurance audits
Evaluate billing system enhancements and implement process improvements
Lead submission, maintenance, management, implementation, and testing of 837 files
Manage Medical Benefit Orders and coordinate with providers and clinics
Partner with Finance, Infusion, and Account Management to improve revenue cycle performance
Support strategic business development efforts with infusion, clinical account pharmacists, and regional sales executives
Collaborate to achieve departmental goals, quality metrics, and organizational objectives

Requirements

What you’ll need

Bachelor’s degree required; an additional four (4) years of experience will be considered in lieu of degree
Five (5) years of experience with third party claims billing, patient collections, or high-volume pharmacy required, including two (2) years of specialty pharmacy, specialty infusion or related business
Two (2) years of progressive leadership/management responsibility required
Specialty pharmacy and copay assistance/foundation billing strongly preferred
Medical billing and 837 claim transaction experience strongly preferred
Strong leadership, coaching and mentoring skills
Excellent written and verbal communication and problem-solving skills
Excellent organizational, process and time management skills
Proven examples of displaying the Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive
Immigration or work visa sponsorship will not be provided for this position

Benefits

Comp & perks

Scorecard incentive eligibility
Full range of benefits
Generous paid time off