Tarrytown Expocare Pharmacy

• Review DME billing for accuracy, compliance, and alignment with payer guidelines. • Verify and correct HCPCS codes, quantities, chart notes, and supporting documentation. • Adjudicate claims and follow up on unpaid claims, rejections, and denials through resolution. • Use billing systems including Frameworks LTC, ECM, and Medbill to process and manage DME claims. • Communicate with pharmacists, technicians, medical professionals, insurance companies, and pharmacy teams across multiple locations. • Identify billing issues, recommend corrections, and help improve claim accuracy and workflow efficiency. • Perform other related duties as assigned.

• Serve as the operations subject matter expert for the Revenue function, working closely with VP- and Director-level leaders to strategically advise on core initiatives, drive execution, and iterate as the organization scales. • Act as Chief of Staff to the Chief Growth Officer (CGO), supporting agenda-setting, meeting preparation, follow-through on strategic priorities, and day-to-day operational leadership of the growth organization. • Manage and continuously refine the prospect-to-client journey, including RFP creation and process optimization, using HubSpot and data-driven tools to maximize conversion, retention, and upsell performance. • Deliver analytical projects including capacity modeling, territory planning, and pipeline forecasting to guide revenue strategy. • Act as the owner for revenue workflows, tech stack, and documentation — identifying inefficiencies, scoping solutions, gathering stakeholder feedback, and driving implementation. • Build and maintain infrastructure standards, workflow documentation, and process playbooks that scale with the business. • Develop and manage KPI dashboards and reporting cadences that keep leadership informed and accountable to key revenue targets. • Proactively surface new ideas and evaluate emerging tools and operational models with a clear eye on ROI and fit within current infrastructure. • Support Enterprise Client activity, including account planning, executive business reviews, and coordination of internal resources to drive retention and expansion across key accounts. • Support Business Development activity by enabling pipeline visibility, partnership tracking, and cross-functional coordination on new growth initiatives. • Own the Sales Methodology Platform, working closely with the Director of Clinical Education and Services to ensure alignment between sales processes, clinical messaging, and training programs. • Maintain a strong connection with Finance and Operations teams to ensure revenue forecasts, headcount plans, and operational resources are aligned with growth objectives.

• Adjudicate insurance claims and resolve rejections in multi-state environment • Properly handle order exceptions such as refill-too-soon, invalid orders, etc. • Working with prescribers to clarify prescriptions and obtain prior authorizations • Manage routine notification of insurance issues and communicate with caregivers • Stay updated on current Medicare/Medicaid policies and common insurance practices • Work with others to resolve common coverage issues or concerns.

• Build and maintain relationships with nurses, physicians, and caregivers • Manage incoming phone calls and emails • De-escalate and troubleshoot issues for customers • Update consumer profiles and medication administration records • Process prescription refills • Submit electronic insurance claims and work rejections • Work with prescribers to clarify prescriptions and obtain refill approvals

• Accurately and efficiently enter new or renewed orders • Adjudicate insurance claims and resolve rejections • Properly handle order exceptions and clarifications such as refill-too-soon, invalid orders, etc. • Communicate effectively with leadership and peers • Achieve or exceed productivity standards in a fast-paced environment

• Serve as a liaison between customers and the company. • Prepare monthly accounts receivable (AR) statements. • Post customer payments by recording check batches, credit card transactions, and electronic transfers in the AR system. • Perform other related duties as assigned.

• Accurately and efficiently enter new orders and refill orders • Properly handle order exceptions such as refill-too-soon, invalid orders, etc. • Handle inbound and outbound calls with other facilities • Identify orders that are valid and those that are invalid, and carry out appropriate order entry and workflow • Adjudicate insurance claims and resolve rejections • Initiate and follow through on refill requests with prescribers • Triage and troubleshoot requests from prescribers and customers • Proactively identify challenges and resulting solutions quickly and follow through on plan of action • Communicate with prescribers, caregivers, leadership, and peers to work effectively together to meet deadlines • Achieve or exceed productivity standards in a fast-paced environment • Stay adherent to Onboarding deadlines and follow through on designated tasks • Package Tracking via Fedex and Courier Services • Become familiar with common EMAR programs (Therap, QuickMAR) and coordinate pharmacy transfers • Perform Facility Training to various audiences to educate on pharmacy processes and online portal

• Market and sell pharmacy services to regional I/DD (Intellectual and Developmental Disabilities) and ICF (intermediate Care Facilities) Communities within the designated territory. • Meet and exceed regional sales goals and quota. • Develop and maintain strong knowledge of I/DD and ICF prospects and contacts in your designated territory. • Coordinate with Chief Sales Officer and team leadership in evaluating and qualifying new sales opportunities. • Conduct “in-person” and “virtual” presentations to prospects in your designated territory. • Experience presenting via Zoom, Teams, and/or RingCentral. • Identify new sales opportunities through prospecting, referrals, market data, CRM, and communicating (verbally and in writing) with I/DD and ICF communities and agencies in the designated territory. • Develop a strategic territory plan including the prioritization and targeting of potential prospects, coordination with tradeshows, State Associations, networking and other marketing initiatives. • Participates in local, state, national trade shows and other marketing initiatives as required. • Complete sales updates, tracking and reporting in a timely and accurate manner. • Documentation of sales activity in Company CRM software. • Coordinates with other pharmacy departments as required including, but not limited, to Operations, Finance, and Leadership team. • Comply with Company policies and procedures.

• Adjudicate insurance claims and resolve rejections in multi-state environment • Properly handle order exceptions such as refill-too-soon, invalid orders, etc. • Working with prescribers to clarify prescriptions and obtain prior authorizations • Manage routine notification of insurance issues and communicate with caregivers • Stay updated on current Medicare/Medicaid policies and common insurance practices • Work with others to resolve common coverage issues or concerns.

• Incident management for pharmacy systems within purview • Subject matter expert for core pharmacy systems (Softwriters Framework LTC and ECM, Integra/Redsail DocuTrack, and related/interfaced systems) • Documentation and knowledgebase management • Develop methodology documents based on self-initiated interviews, diagrams, surveys, and workflow analysis • Research and analyze all aspects of existing business processes and help draft, refine, and promote proposed solutions for advancing automation • Research, identify, track, and communicate incidents and problems with core business applications within purview • Communicate and coordinate with department leadership about common issues that interrupt workflow • Actively participates in the testing and implementation of new software applications as well as test current application functionality when updates are performed • Create/Assist in developing training material to train end-users in the use of software applications • Organizes and prioritizes assigned tasks to meet established schedules, timeliness and/or deadlines • Work independently with minimal supervision • Assist with project management discipline • Assist with change management discipline • Develop/maintain custom reports within Microsoft SQL Reporting Services