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Director of Billing
AmeriPharma
Laguna Hills, CA
Category
Healthcare
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Job Description
AmeriPharma Specialty Care is seeking a Director of Billing to lead and elevate billing operations across both the Medical Benefit (Part B and Major Medical) and Pharmacy Benefit (Part D and PBM) channels.
Requirements
Minimum 8–10 years of progressive leadership in Specialty Pharmacy or Home Infusion Revenue Cycle, with demonstrated accountability for $100M or greater in annual collections.
Advanced expertise in Medical Benefit billing (CMS-1500 and UB-04) and Pharmacy Benefit billing (NCPDP), with deep working knowledge of CPT, HCPCS, J-Codes, ICD-10, and modifier application across infusion, injectable, and specialty drug categories.
Comprehensive understanding of national and regional commercial reimbursement policy, government payer rules, prior authorization frameworks, and specialty distribution dynamics.
Proficiency in data analytics platforms (Power BI, Tableau, Superset, or equivalent) to monitor performance, identify trends, and substantiate reimbursement decisions.
Benefits
Competitive pay and generous compensation structures
Full benefits package including medical, dental, vision, and life that fits your lifestyle and goals
401k program
Comprehensive PTO and sick leave options
Opportunities for growth and advancement
Casual Fridays
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