RCM Contract Implementation Administrator

April 2

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Soleo Health

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Soleo Health is a specialty pharmacy company that goes beyond simply filling prescriptions by providing personalized patient experiences and access to specialized medications and infusion therapies. They offer treatment in patients' homes, in providers' offices, or at one of their many nationwide infusion centers. Soleo Health specializes in treating complex and ultra-rare diseases with a focus on improving patient quality of life and optimizing health outcomes. They work closely with patients, providers, pharmaceutical manufacturers, payors, and health systems to deliver high-cost therapies, demonstrating value through real-world outcome data. Soleo Health is recognized for its clinical excellence and dedication to patient care, and offers nationwide services, including an online portal, Soleo Connect®, for real-time communication.

Anti-infective Therapy • Immunoglobulin Therapy (IV & SCIG) • Bleeding Disorder Therapy • Parenteral Nutrition (TPN) Therapy • Heart Failure Therapy

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🧘 Wellness

📋 Description

• Soleo Health is seeking a full-time RCM Contract Implementation Administrator to work Remotely (USA). • The RCM Contract Implementation Administrator supports Reimbursement Contract Management with implementation of new contracts or amendments to existing agreements via continuous education/training, Reimbursement/Intake staff support and billing audits. • This position requires a high level of communication with internal stakeholders and collaboration with contracted payors, to provide training to internal staff and resolve reimbursement concerns. • Responsibilities include consultation, education and training on payor contract requirements; creating learning aids, SOPs, and resource tools; managing payor-related resources; developing audit programs; conducting confirmation of payor contract rate application on claims; working collaboratively with payors on root cause analysis findings; preparing claim-related reports; and performing other tasks as needed.

🎯 Requirements

• High school diploma or equivalent required, with a degree in related area preferred • At least 5 years of experience in Home Infusion or Specialty Pharmacy medical billing, collections, bill auditing, financial root cause analysis, or closely related field • Must have a solid understanding of Payor Contracts and reimbursement methodologies related to infusion or specialty pharmacy services • Experience with medical infusion billing audit practices and techniques • Experience in diagnosing, isolating and resolving complex issues and recommending/ implementing strategies to resolve issues • Advanced knowledge of medical insurance plans: Managed Care Organizations, Commercial, Medicare Advantage, Self-Funded, TPAs and groups holding financial risk • Advanced knowledge of Home Infusion or Medical Specialty Pharmacy pricing/fee schedules • High level of organization required, with proficiency in the Microsoft suite of products • Experience with developing process documentation/manuals preferred • CPR+ experience preferred

🏖️ Benefits

• Competitive Wages • 401(k) with a Match • Referral Bonus • Paid Time Off • Great Company Culture • Annual Merit Based Increases • No Weekends or Holidays • Paid Parental Leave Options • Affordable Medical, Dental, & Vision Insurance Plans • Company Paid Disability & Basic Life Insurance • HSA & FSA (including dependent care) Options • Education Assistance Program