Responsible for preparing third-party payer agreements for loading into the pharmacy management system and building those agreements within the pharmacy operations system (CPR Plus).
The role researches, interprets, and applies billing rules, billing units, and contract terms to support successful billing and collections for services provided by Option Care. It partners closely with Commercial Contracting, Contract Operations, Revenue Cycle Management, Pricing, Trade, IT, and CMCs to support payer setup, system integration, reporting, and contract maintenance.
Key responsibilities include creating and maintaining payer contract records, auditing pricing tables for accuracy, identifying non-revenue-generating contracts, supporting system upgrades, and providing advanced reports to support revenue cycle and pricing strategies.
- Bachelor's degree, or high school diploma with at least 5 years of experience in Revenue Cycle Management, Contract Management, Home Infusion intake, or home infusion pharmacy technician work
- Strong analytical and problem-solving skills
- Ability to work independently and in cross-functional teams
- Ability to work in a deadline-driven environment
- Advanced Microsoft Excel skills, including VLOOKUPs, basic formulas, and pivot tables
- Experience analyzing and reporting data to identify issues, trends, and exceptions
- Experience with HCPCS coding and drug pricing sources such as AWP, ASP, and WAC
- Intermediate Microsoft PowerPoint and Word skills
- Willingness to travel up to 10% of the time
- Preferred: CPR Plus experience, contract management experience, and knowledge of Medicare, Medicaid, PBM, and third-party payer payment guidelines
- Medical, dental, and vision insurance
- Paid time off
- Bonding time off
- 401(k) retirement savings plan with company match
- HSA company match
- Flexible spending accounts
- Tuition reimbursement
- myFlexPay
- Family support
- Mental health services
- Company-paid life insurance
- Award and recognition programs
Location
Lincoln, Nebraska, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$46,070 - $76,768
Remote work allowed
Yes
Posted
1 month ago