RCM Billing Manager in Sandy, Utah at Aleracare

About Pure Infusion

Pure Infusion is a leading healthcare infusion services company providing high-quality, patient-centered infusion therapy across multiple clinic locations. We have been recognized as the fastest-growing company in Utah for two years in a row as of October 2025. Born from the merger of Pure Infusion Suites and Aleracare, we are building a unified organization grounded in a strong culture of excellence, accountability, and genuine care for patients and employees alike. Headquartered in Salt Lake City, Utah, with operations spanning multiple states, we are in a pivotal stage of growth and integration and we’re looking for people who want to help shape what comes next.

If you’ve been looking for a healthcare position that truly allows you to love on, personally care for, and intentionally work with patients without the chaos of traditional healthcare systems, then Pure is likely what you have been waiting for, we hope you’ll keep reading.

OUR CORE VALUES

We live by four core values that define our culture and guide our hiring:

• People-obsessed
• Relentlessly Improving
• Innovators
• Grateful

In addition to a competitive rates, we offer the following benefits:

• 401(k) Matching
• Health, Vision, and Dental Insurance
• Over 20 days of paid time off annually

The Billing Manager owns the front-end and cash-application integrity of the revenue cycle for our multi-state ambulatory infusion center (AIC) operation — clean claim creation, accurate charge capture on high-dollar specialty drug claims (POS 11), reconciled payment posting, and the operational health of all EDI transactions through the clearinghouse. Partners with the AR & Denials Manager, Patient Access, Coding, and IT to drive cash velocity and minimize denials at the front door. This role is distinct from claims follow-up and denials management, which are owned by a separate manager.

• Own day-to-day clearinghouse operations (Waystar) and EDI transaction sets (837P, 835 ERA, 270/271, 276/277, 277CA/999); resolve rejections within 24 business hours; manage payer ID mapping, EDI/ERA enrollment, and re-enrollment across all payers and TINs.

• Maintain configuration parity between AdvancedMD and Waystar (scrubber rules, custom edits, payer-specific routing); serve as operational owner for clearinghouse transitions, payer consolidations (e.g., Z1274 → PPOONE), and TIN consolidations.

• Supervise charge entry across all AIC sites; enforce NDC/HCPCS dual-reporting, JW modifier, weight-based unit calculation, POS 11 coding; maintain SOPs for high-risk drug classes (specialty biologics, IVIG, biosimilars, monoclonal antibodies); conduct routine charge audits.

• Supervise ERA auto-posting, manual EOB posting, patient payment posting, and reconciliation to bank deposits/lockbox; ensure daily, monthly, and year-end cash close on schedule with unposted cash <2% over 1 business day; govern recoupments, takebacks, refunds, copay assistance, and grant payments.

• Own contractual adjustment accuracy at posting; identify underpayments vs. expected fee schedules and route variances to AR & Denials; maintain controls over remits arriving outside the ERA stream (paper EOBs, payer portals, TPAs).

• Partner with Intake and Clinics to close upstream gaps driving charge errors; hire, train, coach, and performance-manage the team across multiple states; maintain a KPI scorecard; develop SOPs and onboarding curriculum; partner with IT on automation/RPA opportunities.

• Experience: Minimum 7+ years of progressive healthcare revenue cycle experience with at least 2 years of prior supervisory experience over charge entry, payment posting, and/or EDI.

• Technical: Strong working knowledge of 837P/835 transaction sets, clearinghouse operations, payer EDI enrollment, HCPCS/CPT/ICD-10, NDC reporting, NCCI edits, and modifiers relevant to drug administration and infusion billing.

• Skills: Multi-state, multi-payer experience (commercial, Medicare, MA, Medicaid); strong analytics on KPI dashboards, aging reports, and remittance trends; excellent written/verbal communication for executive-level reporting.

Preferred stack: AdvancedMD (PM), WeInfuse / R2 (infusion workflow), Waystar (clearinghouse), Microsoft Excel & Office Suite. Experience with comparable systems plus demonstrated rapid-learning ability will be considered.

• Direct experience in ambulatory infusion (AIC), specialty pharmacy, oncology infusion, rheumatology, or other office-based infusion environments.

• Hands-on Waystar experience (scrubber rule configuration, EDI enrollment, ERA/835 setup, rejection workflow management).

• Merger / TIN consolidation experience, 120-day payer notice management, EDI re-enrollment under successor TINs, ERA re-mapping, clean cutover between legacy and successor entities.

• Certification such as AAHAM, CRCR, or equivalent revenue cycle–related credential