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Associate Director of Specialty Billing - Transplant
Job Description
Our client, a nationally renowned academic medical center and integrated healthcare delivery system, is seeking an Associate Director, Specialty Billing – Transplant to oversee billing and reimbursement operations for strategic priorities, including Transplant and Research. The ideal candidate has extensive experience in Healthcare Revenue Cycle Management, with a specialized focus on Transplant and Research Billing operations and related Compliance. This role requires a deep understanding of the complexities of transplant and research billing processes, as well as knowledge of applicable compliance regulations and best practices. The successful candidate will have a proven track record of managing transplant and research billing while ensuring adherence to all regulatory requirements.
Key Responsibilities:
- Oversee charge capture, billing, and collection functions for hospital Transplant and Research Billing patients in compliance with federal and state regulations and internal policies.
- Process patient referrals and updates within EPIC registration/bundled episodes and transplant access databases.
- Review charges in EPIC charge review work queues (WQS) to ensure accurate billing and appropriate account type/coverage.
- Manage and support transplant programs, including transplant contracting, provider relations, billing, and collections.
- Engage with internal and external stakeholders, including clinics, hospital programs, billing and collections teams, payers, and transplant networks.
- Process case rate allocations for distribution across hospital charges, including: Auditing claims processing and payments, responding to billing and follow-up inquiries related to payment issues, ensuring accurate interpretation and application of contract parameters.
- Maintain compliance with HIPAA, coding, charging, and billing regulations.
- Handle multiple priorities and pivot across various duties as needed.
- This role offers a hybrid work model with a 90% remote structure and onsite requirements in New York.
Qualifications & Experience:
- Bachelor’s Degree required; Master’s Degree preferred.
- 10+ years of experience in Patient Accounting.
- Prior experience in healthcare business office operations, including accounts receivable, collections, billing, and financial counseling.
- Previous managerial experience required; Associate Director or Director-level experience preferred.
- CRCR (Certified Revenue Cycle Representative), HFMA is preferred
- Epic system experience preferred.
- Working knowledge of CPT, ICD-9/ICD-10 coding, and federal/managed care regulations highly preferred.
- Proficiency in Excel, Word, and PowerPoint.
Skills & Competencies:
- Strong communication, organization, and problem-solving skills.
- Ability to effectively discuss billing, collections, and charging matters and interact with patients professionally.
- Excellent written and verbal communication skills.
- Ability to present complex information in a clear and concise manner.
- Strong attention to detail with the ability to manage multiple tasks in a dynamic environment.
Salary: The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.
#LI-FP1
**********Hybrid - Onsite one day a week
Meet Your Recruiter
Fran Philips
Vice President, Healthcare Recruitment
Fran is a seasoned recruiter who joined Tal in 2008, after a long career in medical billing for multi-specialty practices including dermatology, dental, and ophthalmology.
Learn more about Fran, Tal Healthcare Employee Biography
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Associate Director of Specialty Billing - Transplant
Job Description
Our client, a nationally renowned academic medical center and integrated healthcare delivery system, is seeking an Associate Director, Specialty Billing – Transplant to oversee billing and reimbursement operations for strategic priorities, including Transplant and Research. The ideal candidate has extensive experience in Healthcare Revenue Cycle Management, with a specialized focus on Transplant and Research Billing operations and related Compliance. This role requires a deep understanding of the complexities of transplant and research billing processes, as well as knowledge of applicable compliance regulations and best practices. The successful candidate will have a proven track record of managing transplant and research billing while ensuring adherence to all regulatory requirements.
Key Responsibilities:
- Oversee charge capture, billing, and collection functions for hospital Transplant and Research Billing patients in compliance with federal and state regulations and internal policies.
- Process patient referrals and updates within EPIC registration/bundled episodes and transplant access databases.
- Review charges in EPIC charge review work queues (WQS) to ensure accurate billing and appropriate account type/coverage.
- Manage and support transplant programs, including transplant contracting, provider relations, billing, and collections.
- Engage with internal and external stakeholders, including clinics, hospital programs, billing and collections teams, payers, and transplant networks.
- Process case rate allocations for distribution across hospital charges, including: Auditing claims processing and payments, responding to billing and follow-up inquiries related to payment issues, ensuring accurate interpretation and application of contract parameters.
- Maintain compliance with HIPAA, coding, charging, and billing regulations.
- Handle multiple priorities and pivot across various duties as needed.
- This role offers a hybrid work model with a 90% remote structure and onsite requirements in New York.
Qualifications & Experience:
- Bachelor’s Degree required; Master’s Degree preferred.
- 10+ years of experience in Patient Accounting.
- Prior experience in healthcare business office operations, including accounts receivable, collections, billing, and financial counseling.
- Previous managerial experience required; Associate Director or Director-level experience preferred.
- CRCR (Certified Revenue Cycle Representative), HFMA is preferred
- Epic system experience preferred.
- Working knowledge of CPT, ICD-9/ICD-10 coding, and federal/managed care regulations highly preferred.
- Proficiency in Excel, Word, and PowerPoint.
Skills & Competencies:
- Strong communication, organization, and problem-solving skills.
- Ability to effectively discuss billing, collections, and charging matters and interact with patients professionally.
- Excellent written and verbal communication skills.
- Ability to present complex information in a clear and concise manner.
- Strong attention to detail with the ability to manage multiple tasks in a dynamic environment.
#LI-FP1
**********Hybrid - Onsite one day a week
Meet Your Recruiter
Fran Philips
Vice President, Healthcare Recruitment
Fran is a seasoned recruiter who joined Tal in 2008, after a long career in medical billing for multi-specialty practices including dermatology, dental, and ophthalmology.
Learn more about Fran, Tal Healthcare Employee Biography