ASSOCIATE DIRECTOR PAYER REIMBURSEMENT

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

Job summary

An established industry player in healthcare seeks an Associate Director for Payer Reimbursement. This pivotal role involves planning, directing, and coordinating operations to ensure timely payments for hospital services. The ideal candidate will manage financial controls and collaborate with various stakeholders to enhance revenue cycle performance. With a focus on maximizing cash flow and maintaining strong relationships, this position plays a key role in the financial stability of the organization. Join a forward-thinking team dedicated to improving patient revenue through innovative strategies and effective management.

Qualifications

• Minimum of 7 years of experience in healthcare business office functions.
• Bachelor's degree required.

Responsibilities

• Manage payer escalation protocols and vendor relationships.
• Monitor monthly quality performance and review accounts receivable.

Skills

Healthcare business office functions

HIPAA compliance

Communication skills

Problem-solving skills

CPT, ICD-9/ICD-10 coding knowledge

Education

Bachelor's degree

Tools

EPIC system

Excel

Word

PowerPoint

Job description

Associate Director, Payer Reimbursement

The Associate Director, Payer Reimbursement (AD) is responsible for planning, directing, coordinating, and controlling the operations and activities involved with Payer Reimbursement for MMC hospital services. This role also manages the financial control, management, and support of collection and re-bill activities to ensure timely and accurate payment for hospital services. The AD oversees the output and quality of all payer accounts receivable within their scope and collaborates with payer managers and the Senior Director of Revenue Realization to identify strategies for performance improvement on a weekly, monthly, and annual basis.

Key Responsibilities:

• Participate in weekly metrics calls
• Manage vendor relationships
• Monitor monthly quality performance
• Review accounts receivable (AR) regularly
• Manage payer escalation protocols

The AD also focuses on maximizing cash flow by collaborating with internal and external stakeholders, maintaining strong customer relationships, and contributing to daily operations related to billing, collections, follow-up functions, AR analysis, process documentation, and staff training. The role involves working interdependently with other departments to improve workflows and efficiencies impacting patient revenue.

Additional Oversight:

• Coding, billing, and DNFB edits
• EPIC training and work queue management
• Policy reviews
• Denials collaboration
• Transplant case reviews

The AD plays a vital role in ensuring the financial stability of Montefiore Medical Center by setting clear goals, establishing metrics, and fostering sustainable progress.

Qualifications:

Education: Bachelor's degree required. Minimum of 7 years of experience.

Preferred Certifications:

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

Knowledge and Skills:

• Experience in healthcare business office functions (accounts receivable, collections, billing, etc.) preferred
• Knowledge of HIPAA compliance, coding, charging, and billing
• Strong communication, organization, and problem-solving skills
• Proficiency in written and verbal communication
• Ability to present information clearly and concisely
• Knowledge of CPT, ICD-9/ICD-10 coding, and federal/managed care regulations (preferred)
• EPIC system knowledge (preferred)
• Proficiency in Excel, Word, and PowerPoint

Additional Details:

Department: Revenue Cycle

Bargaining Unit: Non-Union

Campus: Tarrytown

Employment Status: Regular Full-Time

Location: 555 South Broadway, Tarrytown

Shift: Day

Hours: 8:30 AM - 5:00 PM

Req ID: 224120

Salary Range: $129,421.50 - $172,562.00

Note: The listed rate is the starting rate and may vary based on experience, shift differential, or other factors.

For more about the Montefiore experience, click here.

Montefiore is an equal opportunity employer committed to diversity and inclusion in the workplace.