Associate Director Payer Reimbursement

Job Description

Our client, a leading healthcare organization committed to delivering exceptional patient care and operational excellence, is hiring an Associate Director, Payer Reimbursement. This pivotal role offers a unique opportunity to lead and optimize the hospital's payer reimbursement processes, ensuring timely and accurate payments for services rendered. The Associate Director will oversee all activities related to payer accounts receivable, collaborate with internal teams and external stakeholders to enhance cash flow, and drive continuous improvement in revenue cycle management. This position is integral to maintaining the financial stability and operational efficiency of the organization, making it an ideal opportunity for a strategic and detail-oriented healthcare finance professional.

Responsibilities

• Plan, direct, and control operations related to Payer Reimbursement for hospital services.
• Manage collection and re-bill activities to ensure accurate and timely payments.
• Oversee the output and quality of all payer accounts receivable under scope.
• Collaborate with payer managers and leadership to develop and implement strategies for performance improvement.
• Monitor weekly, monthly, and annual performance metrics, including vendor management and quality performance.
• Conduct AR reviews, oversee payer escalation processes, and manage denials to optimize cash flow.
• Maintain and enhance internal and external customer relationships.
• Support daily operations related to billing, collections, follow-up, and accounts receivable analysis.
• Develop, document, and implement workflows, processes, and staff training as needed.
• Work with departments to improve efficiencies impacting revenue realization, including coding, billing, and policy reviews.
• Lead efforts in compliance with HIPAA, CPT, ICD-9/ICD-10 regulations, and federal managed care rules.
• Participate in periodic policy reviews, transplant case assessments, and collaboration huddles.
  
  

Requirements

• Bachelor's degree in a healthcare or related field.
• Minimum of 7 years of revenue cycle, billing, or accounts receivable experience.
• Highly preferred certifications: CRCR, HFMA CRCP, or AAHAM.
• Knowledge of healthcare business office operations, including billing, collections, and financial counseling.
• Proficiency with HIPAA, coding (CPT, ICD-9/ICD-10), and billing regulations.
• Excellent communication, organizational, and problem-solving skills.
• Ability to interact professionally with patients and internal stakeholders.
• Strong proficiency in Microsoft Office (Excel, Word, PowerPoint).
• Working knowledge of Epic systems (preferred) and AR management tools.
  
  

Some Of The Benefits

• Opportunities for professional development and certification.
• Collaborative work environment with a focus on innovation.
• Competitive compensation package.
• Engagement in meaningful work that impacts hospital financial health.
• Supportive leadership committed to your growth.
  
  

Salary: The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.