NSN Revenue Resources

Director

• The Payer Reimbursement Director is responsible for leading and overseeing the organization’s payer reimbursement operation.
• Oversee all aspects of Payer Reimbursement, including contract analysis, underpayment recovery, reconciliation, and the Credit Balance & Refunds team.
• Serve as a key liaison between hospitals, payers, and internal stakeholders to drive revenue integrity, ensure contractual compliance, and maximize reimbursement across all surgical hospital facilities.
• Provide strategic leadership to the Payer Reimbursement department, setting goals, KPIs, and performance standards aligned with organizational objectives.
• Collaborate with Revenue Cycle, Billing, Collections, and Payments leadership to streamline workflows and improve efficiency.
• Develop and implement policies, procedures, and best practices to optimize reimbursement accuracy and reduce revenue leakage.
• Track and report on department performance, identifying trends, root causes, and opportunities for improvement.
• Serve as the escalation point for payer issues, refunds, and unresolved reimbursement issues.
• Communicate regularly with hospital executives and revenue cycle leadership regarding payer performance, cash flow impacts, and operational challenges.
• Partner with IT/analytics teams to enhance dashboard reporting and reimbursement tracking tools.
• Lead, coach, and mentor managers of reimbursement analysts, refund specialists, and supervisors.
• Conduct performance reviews, establish development plans, and provide ongoing training to strengthen technical and analytical expertise.
• Foster a culture of accountability, compliance, and continuous improvement.

Director of Payments, Payer Reimbursement