Director of Billing

About AmeriPharma
AmeriPharma Specialty Care is a national specialty pharmacy and home infusion provider serving patients with complex and rare conditions, including IVIG and SCIG therapy, TPN, biologics, oncology support, and rare disease therapies. AmeriPharma operates accredited ambulatory infusion centers and provides home-based infusion nationwide, supported by a fully integrated intake, clinical, and revenue cycle infrastructure. The MedBox division extends AmeriPharma’s mission to senior, home-based, and long-term care populations through medication adherence and multidose packaging services.

Why Join Us?

We're a rapidly growing digital pharmacy where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.

At AmeriPharma, you'll have access to:

• Competitive pay and generous compensation structures
• Full benefits package including medical, dental, vision, and life that fits your lifestyle and goals
• Employee assistance program to assist with mental health, legal questions, financial counseling, and more!
• 401k program
• Comprehensive PTO and sick leave options
• Opportunities for growth and advancement
• Casual Fridays 

Position Summary
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. This leader will own end-to-end professional billing performance for specialty pharmacy, home infusion, infusion suite (AIC), and complex therapy lines, ensuring every service, supply, and medication is captured, coded, and reimbursed accurately, completely, and in full compliance with payer and regulatory requirements.

The Director is accountable for first-pass clean claim performance, reimbursement integrity, denial prevention, and the operational discipline required to convert clinical activity into realized revenue. The role partners closely with Contracting, Intake, Pharmacy Operations, Clinical, and Compliance to ensure billing practices reflect current contract terms, payer policy, and documentation standards.

Key Responsibilities
Operational Leadership
• Dual-Channel Billing Ownership: Direct billing operations across Medical Benefit (J-Codes, HCPCS, CPT, CMS-1500, UB-04) and Pharmacy Benefit (NCPDP) channels, ensuring coordinated revenue capture for therapies billable under either benefit.
• Team Leadership: Lead, mentor, and develop the professional billing staff across specialty pharmacy and infusion lines. Establish clear performance standards, training plans, and career pathways.
• Workflow Discipline: Audit and refine billing workflows to remove rework, reduce touch points, and shorten the cycle from service date to clean claim submission. Implement automation where appropriate for claim edits, eligibility verification, and secondary claim routing.
• Cash Posting Oversight: Oversee pharmacy and professional medical cash posting operations, ensuring accurate, timely, and fully reconciled posting of payments, adjustments, and remittances across both benefit channels. Maintain controls that support clean AR aging, accurate reporting, and audit readiness.

Reimbursement Integrity
• Coding Accuracy and Modifier Review: Conduct structured reviews of code selection, modifier application (including JW, JZ, and infusion-specific modifiers), units billed, and place-of-service designations to ensure each claim accurately reflects the service provided and the payer’s coverage policy.
• Pre-Submission Validation: Establish formal pre-billing audit and validation protocols, including small-volume claim validation cycles to confirm payer acceptance of new codes, modifiers, or product NDCs before broad submission. All validation activity is documented, evidence-based, and grounded in published payer policy and contract terms.

• Ancillary Service Capture: Ensure all billable components of complex therapies — including nursing administration, supplies, clinical monitoring, and pharmacist clinical services — are documented and submitted in accordance with payer policy and AmeriPharma contracts.
• Den