ASSOCIATE DIRECTOR PAYER REIMBURSEMENT

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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

Vendor Management

Monthly Quality Performance

365+ AR Review

Payer Escalation Protocol management

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.

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

Coding/Billing/DNFB Edits

EPIC Training

EPIC Work Queue management

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: filter14 Bargaining Unit: filter11 Campus: filter12 Employment Status: filter1 Address: filter4

Shift: filter2 Scheduled Hours: filter6 Req ID: id Salary Range/Pay Rate: customSalmin - customSalmax customRate

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.

To learn more about the "Montefiore Difference" - who we are at Montefiore and all that we have to offer our associates, please click .

Diversity, equity and inclusion are core values of Montefiore. We are committed to recruiting and creating an environment in which associates feel empowered to thrive and be their authentic selves through our inclusive culture. We welcome your interest and invite you to join us.

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.

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