Director, Payment Variance

Job Purpose

The Director, Payment Variance will mentor, monitor and evaluate the Underpayment Collections. This position will consistently communicate with the Assistant Vice President, Managed Care to ensure efficiency and productivity in the everyday operations and recovery process. The Team is responsible for collecting outstanding insurance balances left open due to contractual discrepancies and insurance payer underpayments.

Duties And Responsibilities

• Perform payment variance analysis to identify trends in underpaid claims
• Perform denials analysis to identify trends in denial patterns
• Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results
• Identify and report underpayments and denial trends
• Ability to analyze, identify and resolve issues causing payer payment delays including billing and coding errors
• Managed team productivity to ensure departmental goals are achieved
• Develop and mentor team member, provide career coaching motivating and supporting all employees.
• Provide the appropriate orientation to new and existing employees. Give the information, technology and reference materials necessary to perform their job
• Responsible for ensuring that all work is done properly on a timely manner
• Perform internal audits of everyday recoveries
• Report and trend revenue by client, staff, etc
• Compile together client reporting packages, provide clients with regular updates on project status
• Hold quarterly staff meetings/learning sessions
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients
• Maintain confidentiality at all times
• Maintain a professional attitude
• Other duties as assigned
• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  
  

Qualifications

• Bachelor’s degree in a related field preferred
• Minimum 10 years progressively responsible experience in health care revenue cycle or underpayments recovery services
• Working knowledge of the insurance follow-up process with and understanding of the fundamental concepts in healthcare reimbursement methodologies
• Detailed knowledge of Managed Care reimbursement methodologies
• Must have excellent computer skills including Microsoft Windows, Outlook, Word and Excel
• Must have leadership experience and the ability to manage employees.
• Proficiency in business writing and email correspondence
• Ability to multi-task and prioritize under stressful situations
• Proficiency in Microsoft Office Suite
• Strong interpersonal skills, ability to communicate well at all levels of the organization
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results oriented
• Excellent written and verbal communication skills required
• Gracious and welcoming personality for customer service interaction
  
  

Working Conditions

• Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.
  
  

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.