Alto Pharmacy
Specialty Pharmacy
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Job Description
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.
Key Responsibilities
Team Leadership & Management: Supervises billing and AR staff, assigning daily work, training new employees, and mentoring team members on billing techniques.
Workflow Optimization: Develops and implements policies, procedures, and best practices to improve billing efficiency and revenue integrity.
AR Management & Collections: Monitors AR aging reports to identify and resolve delinquent accounts, underpayments, and denials.
Claim Adjudication & Appeals: Manages the resolution of rejected claims, submits appeals for denied claims, and reconciles pharmacy payments.
Compliance & Auditing: Ensures compliance with HIPAA, state/federal regulations, and payer contracts (Medicare, Medicaid, commercial).
Reporting: Generates and analyzes financial reports, tracking key performance metrics for pharmacy leadership.
Communication: Serves as a liaison between the pharmacy staff, finance department, and insurance payers regarding billing issues.
Key Performance Indicators (KPIs)
Reduced Days Sales Outstanding (DSO) in Accounts Receivable.
High first-pass claim acceptance rates.
Minimal write-offs and bad debt.
Improved denial resolution turnaround time.
Qualifications and Skills
Experience: 10+ years overall billing, collection, and AR management, with 3 - 5+ years of experience in medical/pharmacy billing and team leadership.
Knowledge: Strong understanding of pharmacy adjudication systems and third-party payer rules.
Technical Skills: Proficiency in pharmacy management software, preferably Inmar, and Microsoft Excel.
Performance Management: Demonstrated track record of driving operational excellence and delivering high-quality results.
Soft Skills: Strong analytical, problem-solving, and communication skills, with the ability to lead in a fast-paced environment.
Preferred Requirements
Bachelor’s degree in Business, Finance, or Healthcare Administration or related field.
Experience with 340B claims management
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.
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.
Salary Range: $110,400-$138,000
Commission Eligible: No
Travel: No
Location Requirement:
FuzeRx 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
Employment Authorization Requirement: 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.
Benefits - Fuze Health 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&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.
More Benefits Information Here: Fuze Health Benefits Site
The application deadline is June 16, 2026. This application deadline may be extended based on business needs.
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Equal Opportunity Employer
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 talent@fuzehealth.com.
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.
Use of Automated Decision Tools
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 at talent@fuzehealth.com.
Privacy Notice
To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our Privacy Notice for Job Applicants.
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