Lead Specialist, Revenue Cycle Management

Company: Option Care Health
Location: Springfield
Posted on: July 1, 2025

Job Description:

Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and employees. As a two-year recipient of the Gallup Exceptional Workplace Award, we recognize that part of being extraordinary is building a thriving workforce that is as unique as the patients and communities we serve. Join a company that is taking action to develop a culture that is inclusive, respectful, engaging and rewarding for all team members. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare. Job Description Summary: Acts as a lead, coordinating the work of Reimbursement Specialists. Resolves more complex inquiries and/or complaints escalated by the Reimbursement Specialists. Performs all duties of the Reimbursement Specialist job. Job Responsibilities: • Acts as a resource for colleagues; may direct the work of other staff members. • May assist in training of new team members and may provide input to the employees’ performance evaluations. • Acts as Subject Matter Expert and works autonomously to handle more complex issues related to the collections, within established procedures and practices. • Submits timely, accurate invoices to payer for products and services provided. Understands the terms and fee schedule for all contracts for which invoices are submitted. Correctly determines quantities and prices for drugs billed. Verifies that the services and products are correctly authorized and that required documentation is on file. Ensures that invoices are submitted for services and products that are properly ordered and confirmed as provided. • Evaluates payments received for correctness and applies payments accurately to the system. Verifies that payments received are correct according to the fee schedule. Applies the payment correctly to the patient account. Ensures that secondary bills and patient invoices are mailed within 48 hours of receipt of payment. • Follows up on invoices submitted to ensure prompt and timely payment. Calls to verify that claims submitted were received and are in processing. Sends letters to the patient or responsible party when their insurance carrier fails to make payment reasonable time frame. Generates and mails statements and collections letters per Option Care policy. Follows-up on all denials within 48 hours of receipt. • Ensures compliance with policies and guidelines outlined in the contract terms and fee schedule. Follows HIPPA guidelines when accessing and sharing patient information to maintain patient and business confidentiality. Supervisory Responsibilities: i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc. Basic Education and/or Experience Requirements: • High School Diploma or equivalent • Minimum 1 year of healthcare intake/admission and/or reimbursement experience • Demonstrated leadership and complex problem-solving capabilities Basic Qualifications & Interests: • Experience in identifying operational issues and recommending and implementing strategies to resolve problems. • Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling). • Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions). Preferred Qualifications & Interests: • Certified Professional Coder (CPC) from AAPC or AHIMA

Keywords: Option Care Health, O'Fallon , Lead Specialist, Revenue Cycle Management, Customer Service & Call Center , Springfield, Missouri