icims
Executive Director - Payer Denial Recovery
Piedmont Healthcare Inc.
Remote, USA
Full-time
Senior · 10+ years experience
Remote
Discovered 4 weeks ago
Epic
Key Skills for This Role
Epic
Full Job Posting
- Bachelor’s Degree in Business Administration, Healthcare Administration, Finance, Accounting, Health Information Management, or related field required Required
• Master’s Degree Preferred
- 10 years of leadership experience in revenue cycle operations, consulting, reimbursement management, payer relations, and/or project management to include five (5) years of senior leadership experience Required
- Knowledge of the entire revenue cycle with specific expertise in:
- Denials Management
- Appeals Operations
- Payer Recoveries
- Hospital and Physician Billing
• Managed Care Reimbursement
- Contract Compliance
- Underpayment Recovery
- Revenue Integrity
• Regulatory Dispute Resolution
- Payment Variance Analysis within a progressive healthcare environment. Required
- Experience managing two or more: commercial payer disputes, government payer disputes, recoupment defense activities, Independent Dispute Resolution (IDR), payer audit responses, contract compliance initiatives, underpayment recovery programs with a strong understanding of: Hospital and Physician Revenue Cycle Operations, No Surprises Act, Medicare and Medicaid Reimbursement, Payer Audit Programs, Payment Integrity Programs, Revenue Integrity Methodologies. Required
- Experience leading large-scale operational transformation, centralization, and process improvement initiatives Required
- Revenue Cycle leadership in a multi-hospital and employed physician environment with over $2B in net revenue Preferred
- Previous experience using or implementing Epic, advanced knowledge of Epic Revenue Cycle applications and reporting tools Preferred
- Experience leading enterprise denial management and payer recovery operations Preferred
- Lean Six Sigma Black Belt, HFMA Certification, CRCR, RHIA, RHIT, CPC, or other healthcare financial certification Preferred
About Piedmont Healthcare Inc.
Hospitals & Health Systems50000 employeesFounded 1905
Private, not-for-profit health system providing care across Georgia.
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