About the position
The Associate Director, Payer Reimbursement (AD) is responsible for planning, directing, coordinating, and controlling the operation and activities involved with Payer Reimbursement for MMC hospital services. Additionally, this position is responsible for the financial control, management, and support of the collection and re-bill activities ensuring timely and accurate payment for hospital services. The Associate Director, Payer Reimbursement (AD) manages and oversees the output and quality of all payer accounts receivable under their scope and is expected to collaborate with their payer managers and the Senior Director of Revenue Realization to identify strategies for performance improvement on a weekly, monthly, and annual basis. The AD is also responsible for maximizing cash flow, so collaboration with key stakeholders, both internal and external, is essential. Maintaining and improving these internal and external customer relationships is equally as important. In conjunction with other duties, the AD will contribute to the day-to-day operations on all issues related to billing, collections and follow-up functions, provide AR analysis, create written processes and procedures, and identify and implement required training for the Revenue Realization staff, which may or may not require interaction with individuals outside of Revenue Realization. The AD will work interdependently with other departments and their key stakeholders to create improved workflows and efficiencies across departments where there is an impact, directly or indirectly, on (cash) patient revenue. The AD holds an essential responsibility for ensuring stability of Montefiore Medical Center's (MMC) financial health as the staff he/she supervises, and their associated functions play a large role in reimbursement and cash flow. This individual sets clear and achievable goals and establishes the necessary metrics to track, monitor, and facilitate sustainable progress.
Responsibilities
- Weekly Metrics Call
- Vendor Management
- Monthly Quality Performance
- 365+ AR Review
- Payer Escalation Protocol management
- Coding/Billing/DNFB Edits
- EPIC Training
- EPIC Work Queue management
- Annual/Bi-Annual Policy Review
- Denials Huddle Collaboration
- Monthly Transplant Case Review
Requirements
- Bachelor's degree required.
- Seven (7) years experience.
- Healthcare business office experience (in areas such as accounts receivable, collections, billing, financial counseling etc.) preferred.
- Experience with HIPAA compliance, coding, charging and billing.
- Excellent communication, organization, and problem-solving skills required.
- Ability to present information in a clear, concise manner is a must.
- Working knowledge of CPT, ICD-9/ICD-10 coding, and Federal/managed care rules and regulations preferred.
- Working knowledge of Excel, Word, and PowerPoint is required.
Nice-to-haves
- CRCR (Certified Revenue Cycle Representative), HFMA
- CRCP (Certified Revenue Cycle Professional), AAHAM
- Epic system knowledge preferred.
Benefits
- Regular Full-Time employment status
- Salary Range/Pay Rate: $129,421.50 - $172,562.00
