ASSOCIATE DIRECTOR PAYER REIMBURSEMENT

Montefiore Health System; Village of Tarrytown (NY); On-site; USD 129,000 - 173,000; Full time

Job summary

An established industry player is seeking an Associate Director for Payer Reimbursement to lead operations in ensuring timely payments for hospital services. This role involves financial management, collaboration with internal and external stakeholders, and oversight of accounts receivable processes. The ideal candidate will have a Bachelor's degree and extensive experience in healthcare billing and collections. You will contribute to the financial health of the organization while fostering relationships that enhance service delivery. Join a mission-driven team dedicated to improving community health and delivering excellence in patient care.

Qualifications

• Bachelor's degree required with 7 years of experience in healthcare reimbursement.
• Strong knowledge of billing, collections, and financial counseling preferred.

Responsibilities

• Plan and oversee payer reimbursement operations for hospital services.
• Collaborate with stakeholders to improve cash flow and billing processes.

Skills

Communication Skills

Problem-Solving Skills

Financial Counseling

HIPAA Compliance

CPT Coding

ICD-9/ICD-10 Coding

Education

Bachelor's Degree

Tools

EPIC System

Excel

Word

PowerPoint

Job description

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.

Examples of tasks and/or oversight associated with this role include:

• Weekly Metrics Call
• Monthly Quality Performance
• 365+ AR Review

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. 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.

Examples of tasks and/or oversight associated with this role include:

• EPIC Training
• Annual/Bi-Annual Policy Review
• Denials Huddle Collaboration
• Monthly Transplant Case Review

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.

EDUCATION: Bachelor's degree required. Seven (7) years experience.

Highly preferred certifications:

• CRCR (Certified Revenue Cycle Representative), HFMA
• CRCP (Certified Revenue Cycle Professional), AAHAM

KNOWLEDGE:

• 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. Candidate must be comfortable discussing billing, collections, and charging matters, as well as the ability to interact with patients in a professional manner.
• Excellent written and verbal skills.
• 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.
• Epic system knowledge preferred.
• Working knowledge of Excel, Word, and PowerPoint is required.

Department: Revenue Cycle

Bargaining Unit: Non Union

Campus: TARRYTOWN

Employment Status: Regular Full-Time

Address: 555 South Broadway, Tarrytown

Shift: Day

Scheduled Hours: 8:30 AM-5 PM

Req ID: 224120

Salary Range/Pay Rate: $129,421.50 - $172,562.00

For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.

Montefiore is an equal employment opportunity employer.

Mission:
To heal, to teach, to discover and to advance the health of the communities we serve.

Vision:
To be a premier academic medical center that transforms health and enriches lives.

Values:
Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

• Humanity
• Teamwork
• Diversity
• Equity

Nearest Major Market: White Plains
Nearest Secondary Market: New York City