Associate Director Payer Reimbursement

Bronx, NY 10591

Department: Revenue Job Number: 6593 Pay Rate: $100000-120000 Employment Type: Full Time

Job Description

Our client is a nationally renowned academic medical center and integrated healthcare delivery system committed to providing high-quality patient care, medical education, and innovative research.

Position Summary:
The Associate Director, Payer Reimbursement (AD) is responsible for overseeing the planning, coordination, and execution of payer reimbursement activities for hospital services. This role ensures financial control and efficient management of collections and re-billing activities to guarantee timely and accurate payments. The AD oversees all payer accounts receivable under their scope, working closely with payer managers and the Senior Director of Revenue Realization to identify and implement performance improvement strategies on a weekly, monthly, and annual basis.

Key Responsibilities:

  • Direct and manage all activities related to payer reimbursement for hospital services.

  • Develop and implement strategies to optimize revenue realization and improve cash flow.

  • Collaborate with internal and external stakeholders to maintain and enhance customer relationships.

  • Oversee key operational processes, including billing, collections, follow-up functions, and accounts receivable analysis.

  • Develop and maintain written processes and procedures related to payer reimbursement.

  • Identify and implement necessary training programs for Revenue Realization staff.

  • Establish clear, measurable goals and performance metrics to track progress and ensure financial stability.

  • Collaborate with various departments to enhance workflow efficiencies impacting patient revenue.

Operational Oversight Includes:

  • Weekly Metrics Call

  • Vendor Management

  • Monthly Quality Performance Reviews

  • 365+ AR Review

  • Payer Escalation Protocol Management

  • Coding/Billing/DNFB Edits

  • EPIC Training & Work Queue Management

  • Annual/Bi-Annual Policy Review

  • Denials Huddle Collaboration

  • Monthly Transplant Case Review

Qualifications & Requirements:

  • Bachelor's degree required.

  • Minimum of seven (7) years of experience in healthcare revenue cycle management.

  • Strong knowledge of healthcare business office operations, including accounts receivable, collections, billing, and financial counseling.

  • Expertise in HIPAA compliance, coding, charging, and billing.

  • Proficiency in CPT, ICD-9/ICD-10 coding, and federal/managed care rules and regulations.

  • Experience with EPIC system preferred.

  • Strong problem-solving, organizational, and communication skills.

  • Ability to present complex information in a clear and concise manner.

  • Proficiency in Microsoft Excel, Word, and PowerPoint.

Preferred Certifications:

  • CRCR (Certified Revenue Cycle Representative) – HFMA

  • CRCP (Certified Revenue Cycle Professional) – AAHAM

This is an excellent opportunity for a dynamic and results-driven professional to play a key role in the financial health of a leading academic medical center. If you have the skills and experience required, we encourage you to apply.

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.

***Hybrid - Onsite one day a week
 
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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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