Director of Payments, Payer Reimbursement
NSN Revenue Resources
full-time
Posted on:
Location Type: Hybrid
Location: Dallas • Texas • United States
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Job Level
About the role
- 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.
Requirements
- Bachelor’s degree in finance, Healthcare Administration, Business, or related field preferred and/or 7-10 years of experience in payer reimbursement or revenue cycle management a must.
- At least 3-5 years in a leadership or director-level role overseeing payer relations, contract management, or reimbursement operations.
- Strong knowledge of managed care contracts, payer reimbursement methodologies, and regulatory requirements related to refunds and credit balances.
- Proven experience leading cross-functional teams and implementing process improvements.
- Excellent analytical, negotiation, and communication skills.
Benefits
- WFH Flexible 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
contract analysisunderpayment recoveryreconciliationreimbursement accuracyrevenue cycle managementmanaged care contractspayer reimbursement methodologiesregulatory requirementsprocess improvementsdashboard reporting
Soft Skills
leadershipcommunicationanalytical skillsnegotiationcoachingmentoringperformance managementcollaborationaccountabilitycontinuous improvement