Manager Business Office - Home Infusion

Fairview Health Services•Shoreview, MN

About The Position

Manager of Business Office will lead, optimize, and help scale the full revenue cycle operation within our Home Infusion division. This leadership position with comprehensive accountability for every phase of the revenue cycle—from the moment a patient is referred through final payment posting and reconciliation. The role carries dual responsibility: driving the performance, compliance, and strategic direction of all internal business office functions while simultaneously serving as a subject-matter expert and revenue cycle consultant to external home infusion pharmacy clients. The Manager of Business Office will directly oversee the Patient Access team, ensuring accurate and timely patient onboarding, demographic capture, insurance eligibility verification, and benefit investigation for all new and existing patients. This includes establishing standardized intake workflows that accelerate the speed to therapy initiation while safeguarding data integrity and payer compliance from the outset of every patient encounter. This leader will manage the Prior Authorization and Benefit Verification teams, who are responsible for securing initial and ongoing authorizations across all payer classes—including commercial insurers, Medicare, Medicaid, managed care organizations, and workers' compensation carriers. The Manager will develop payer-specific authorization strategies, escalation protocols, and turnaround-time standards to ensure that no patient experiences a delay in therapy due to administrative barriers. They will monitor authorization denial trends, implement corrective action plans, and maintain proactive communication with clinical and pharmacy teams to align authorization timelines with patient care plans. The position holds direct responsibility for the Patient Advocacy function, ensuring that patients receive comprehensive financial counseling, assistance navigating copay assistance programs, manufacturer patient assistance programs, independent foundation grants, and government-sponsored aid. The Manager will build a patient advocacy model that reduces patient financial burden, minimizes bad debt exposure, and supports therapy adherence by removing cost-related barriers to care. On the reimbursement side, this role oversees the full claims management lifecycle—from clean claim submission through aggressive follow-up on unpaid, underpaid, denied, and rejected claims. The Manager will lead the Reimbursement Follow-Up team in executing structured work queues, managing payer-specific appeal strategies, conducting root cause analysis on denial trends, and escalating complex disputes to resolution. They will be accountable for maintaining industry-leading benchmarks in days in accounts receivable, clean claim rates, denial overturn rates, and net collection percentages. The Manager will also oversee Cash Application operations, ensuring that all payments, including electronic remittance advice (ERA), manual EOBs, patient payments, and bulk wire transfers—are posted accurately and within established timelines. They will enforce rigorous reconciliation processes between cash receipts, bank deposits, and the billing system, and will ensure contractual adjustments, write-offs, and payment variances are identified, documented, and resolved according to policy. Beyond internal operations, this position plays a critical external-facing role as a senior consultant representing Fairview Pharmacy Solutions to outside home infusion pharmacy clients. The Manager will conduct comprehensive revenue cycle assessments, operational audits, and gap analyses for client organizations. They will design and deliver customized consulting engagements—including workflow optimization, staff training programs, KPI benchmarking, payer strategy development, and standard operating procedure creation—tailored to each client's unique payer mix, patient population, and operational maturity. The Manager will serve as a trusted strategic advisor, building long-term client relationships and contributing to business development through proposals, industry presentations, and thought leadership. This role requires a leader who can operate at both the strategic and tactical levels: setting the vision and financial targets for the business office while also diving into claim-level detail when needed to resolve complex reimbursement challenges. The ideal candidate combines deep technical expertise in home infusion billing and payer reimbursement with exceptional leadership, communication, and consulting skills—and brings a proven track record of building high-performing teams, improving cash collections, reducing denial rates, and delivering measurable financial outcomes across both internal and client-facing engagements.

Requirements

Bachelor of Arts Healthcare Administration, Business, Finance or equivalent area
5 years Progressive experienced in revenue cycle management within a home infusion, specialty pharmacy, or infusion services environment
3 years Supervisory or management role with direct oversight of multidisciplinary business office teams
3 years Demonstrated success improving key revenue cycle metrics (A/R days, denial rates, net collections)
Expert-level knowledge of home infusion billing, coding (HCPSC, ICD-10, NDC) and payer reimbursement methodologies across Medicare, Medicaid, and commercial payers
Strong understanding of HIPPA, accreditation standards (ACHC/URAC), and state/federal regulatory requirement
Exceptional communication, presentation, and interpersonal skills with the ability to influence across all levels of the organization and with external stakeholders
Proficient in Microsoft Office Suite (Excel, Word, Outlook, Teams) and experience with CRM or case management platforms

Nice To Haves

M.A./M.S. Master's Degree - MBA, MHA or relevant advanced certification (e.g. - CRCR, CRCE, CHFP, CPB)
2 years Prior experience in a consulting or client facing advisory role within the home infusion or specialty pharmacy spaces

Responsibilities

Provide end-to-end oversight of the entire revenue cycle, from patient intake through final cash application, ensuring operational excellence across all functions.
Establish, monitor, and report on key performance indicators (KPIs) including days in A/R, clean claim rate, denial rate, net collection rate, and cash posting accuracy.
Architect and implement process improvements, automation strategies, and workflow redesigns that accelerate cash flow and reduce revenue leakage.
Partner with clinical, pharmacy, and IT leadership to ensure seamless integration between clinical workflows and billing operations.
Direct the Patient Access team responsible for new patient onboarding, demographic and insurance data capture, and eligibility verification.
Oversee the Patient Advocacy function, ensuring patients receive financial counseling, assistance with copay programs, manufacturer assistance, and foundation grants.
Lead the Prior Authorization and Benefit Verification teams in obtaining timely and accurate authorizations, ensuring therapy initiation is not delayed by administrative barriers.
Develop payer-specific workflows and escalation protocols to minimize authorization denials and therapy disruptions.
Manage the Reimbursement Follow-Up team in aggressively pursuing outstanding claims, underpayments, and denied or rejected claims across all payer classes (commercial, government, managed care, and workers’ compensation).
Oversee Cash Application operations to ensure payments are posted accurately and timely, variances are identified, and reconciliation processes are rigorous.
Drive denial management strategy including root cause analysis, appeal writing, payer escalation, and trend reporting to prevent recurrence.
Negotiate and resolve complex payer disputes and contractual underpayment issues.
Serve as a consultant to external home infusion pharmacy clients, conducting revenue cycle assessments, gap analyses, and operational audits.
Support on the development and delivery of customized consulting solutions, playbooks, training programs, and standard operating procedures tailored to each client’s unique payer mix and operational challenges.
Build and maintain long-term client relationships, acting as a trusted advisor on reimbursement strategy, payer trends, and regulatory changes.
Contribute to business development efforts by supporting proposals, attending industry events, and supporting new consulting opportunities.
Recruit, mentor, and develop a high-performing business office team across all revenue cycle disciplines.
Foster a culture of accountability, continuous improvement, and professional growth.
Conduct regular performance evaluations, provide coaching, and implement succession planning for key roles.
Ensure ongoing staff education on payer policy changes, HIPAA compliance, and industry best practices.