Director of Payer Relations

Rehab Medical; Indianapolis (IN); Sur place; USD 90 000 - 130 000; Plein temps

Résumé du poste

A leading medical equipment manufacturer in Indianapolis is seeking a Director of Payer Relations. This role involves managing relationships with Medicare, Medicaid, and insurance companies, optimizing contracts, and ensuring accurate claims processing. Candidates should possess a Bachelor's degree, a minimum of 7 years in payer relations, and a strong understanding of medical payer policies. Exceptional analytical and negotiation skills are essential to support the company's growth and strengthen payer coverage across various service lines.

Qualifications

• Bachelor’s degree in Business, Finance, Healthcare Administration, or related field (Master’s preferred).
• Minimum of 7+ years of experience in payer relations, contracting, or reimbursement within the DME/CRT or healthcare industry.
• Strong knowledge of Medicare, Medicaid, and commercial payer policies, especially as they relate to DMEPOS and CRT.
• Proven experience in payer contract negotiations, rate setting, and dispute resolution.
• Deep understanding of revenue cycle operations including claims submission, denial management, and reimbursement analysis.
• Exceptional relationship management skills with the ability to collaborate across payers, internal teams, and executive leadership.
• Excellent analytical, communication, and negotiation skills.
• Familiarity with HCPCS coding, payer fee schedules, and CMS guidelines.

Responsabilités

• Establish and maintain successful contracting relationships with major payors.
• Lead the negotiation of payer contracts and monitor payer fee schedules.
• Partner with the Revenue Cycle Director to ensure compliant claims submissions.
• Identify and implement process improvements to reduce denials and improve collections.
• Analyze trends in payer behavior to provide insights for company strategy.

Description du poste

About Us

Rehab Medical is on a mission to transform lives through innovative custom mobility solutions. As one of the nation’s leading providers of complex rehab technology (CRT), we’ve empowered over 250,000 people to regain their independence over our 20‑year history. Headquartered in Indianapolis, Indiana, our award‑winning company is recognized for its commitment to growth, ethics, and making a difference. Join our team and become part of a company that values your impact as much as the lives we improve every day.

Position Summary

The Director of Payer Relations will serve as the primary liaison between the company and its payer partners, including Medicare, Medicaid, and commercial/private insurance companies. This individual will be responsible for ensuring that payer relationships are strategically managed, contracts are optimized, and claims are billed and reimbursed correctly. The role will work closely with the Revenue Cycle Director and Director of Finance to align payer operations with company objectives, improve reimbursement accuracy, and mitigate any claim or payment issues. Additionally, this leader will drive payer contracting efforts, including securing new agreements, renegotiating rates, and addressing operational issues impacting billing and collections.

Key Responsibilities

Payer Relations & Contract Management

• Establish and maintain successful contracting relationships with major payors such as United Healthcare, Aetna, Humana and BCBS.
• Lead the negotiation of payer contracts, including new agreements, renewals, and rate adjustments.
• Monitor and analyze payer fee schedules, reimbursement policies, and contract compliance.
• Collaborate with payers to resolve operational or claims processing issues that impact revenue cycle.

Revenue Cycle & Finance Collaboration

• Partner with the Revenue Cycle Director to ensure claims are submitted accurately, timely, and in compliance with payer rules.
• Work with the Director of Finance to validate reimbursement accuracy, identify underpayments, and escalate discrepancies.
• Oversee payer set‑up in internal systems to ensure proper billing, coding, and contract application.
• Identify and implement process improvements to reduce denials, improve collections, and optimize cash flow.
• Develop and maintain strong working relationships with payer representatives to address claim denials, underpayments, and payment delays.
• Facilitate regular meetings with payers to resolve operational bottlenecks, compliance concerns, and policy misalignments.
• Act as an escalation point for unresolved payer issues impacting revenue recognition or patient care.

Strategic Leadership

• Analyze trends in payer behavior, reimbursement, and policy changes to provide insights for company strategy.
• Partner with executive leadership to forecast financial impacts of contract terms and reimbursement changes.
• Educate internal teams on payer requirements, new contracts, and reimbursement methodologies.
• Support company growth initiatives by ensuring payer coverage aligns with expansion into new states or service lines.

Qualifications

• Bachelor’s degree in Business, Finance, Healthcare Administration, or related field (Master’s preferred).
• Minimum of 7+ years of experience in payer relations, contracting, or reimbursement within the DME/CRT or healthcare industry.
• Strong knowledge of Medicare, Medicaid, and commercial payer policies, especially as they relate to DMEPOS and CRT.
• Proven experience in payer contract negotiations, rate setting, and dispute resolution.
• Deep understanding of revenue cycle operations including claims submission, denial management, and reimbursement analysis.
• Exceptional relationship management skills with the ability to collaborate across payers, internal teams, and executive leadership.
• Excellent analytical, communication, and negotiation skills.
• Familiarity with HCPCS coding, payer fee schedules, and CMS guidelines.

Seniority Level

Director

Employment Type

Full‑time

Job Function

Business Development and Sales

Industries

Medical Equipment Manufacturing