Director, Payment Variance

Med-Metrix•Parsippany-Troy Hills, NJ

About The Position

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.

Requirements

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

Nice To Haves

Bachelor’s degree in a related field preferred

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