ASSOCIATE DIRECTOR SPECIALTY BILLING

The Revenue Cycle Department has a new opportunity available for the role of Associate Director of Specialty Billing. The role includes operational responsibilities for billing and reimbursement for strategic priorities to include in the Transplant and Research.

The ideal candidate has experience in Healthcare Revenue Cycle, specifically in Transplant and Research Billing operations, as well as expertise in Compliance related to these areas.

Candidates should possess a deep understanding of the intricacies involved in healthcare revenue cycle management, particularly in the context of transplant and research billing processes.

Additionally, a comprehensive knowledge of relevant compliance regulations and best practices is essential. The ideal candidate will have a proven track record of successfully navigating the complexities of transplant and research billing while ensuring adherence to all applicable compliance requirements.

The daily responsibilities in this role will include but not be limited to the following :

• Manage the day-to-day operation and the progression of charge capture, billing, and collection functions of hospital Transplant and Research Billing patients in accordance with federal and state billing and compliance guidelines as well as internal policies.
• Processing patient referrals / updates within EPIC registration / bundled episodes and transplant access database.
• Reviewing charges in EPIC charge review WQS to ensure billing on correct guarantor account type / coverage.
• Experience working with transplant programs including, but not limited to transplant contracting, transplant provider relations, transplant billing and collections, etc.
• Must be able to multi-task and pivot across duties as needed.
• Interact with a variety of internal and external customers i.e., clinics, hospitals programs, billing / collections teams for hospital, payers, transplant network, etc.
• Processing case rate allocations for distribution across hospital charges which includes :
• Auditing of claims processing / payments.
• Responding to billing / follow-up inquiries when payment issues / questions arise.
• All duties require understanding, interpretation, and application of contract parameters to complete.

This a 90% remote position with onsite requirement at our NY City locations.

Bachelor’s Degree required, Master’s preferred.

Patient Accounting Exp 10 years or more

Highly preferred certifications :

• CRCR (Certified Revenue Cycle Representative), HFMA
• Previous experience as a manager required , Associate Director or Director preferred.
• Healthcare business office experience (in areas such as accounts receivable, collections, billing, financial counseling etc.) required
• Experience with HIPAA compliance, coding, charging, and billing.
• Excellent communication, organization, and problem-solving skills required. Candidate must be comfortable discussing billing, collections, and charging matters, as well as the ability to interact with patients in a professional manner.
• Excellent written and verbal skills.
• Ability to present information in a clear, concise manner is a must.
• Working knowledge of CPT, ICD-9 / ICD-10 coding and Federal / managed care rules and regulations highly preferred.
• Epic system experience preferred.
• Working knowledge of Excel, Word, and PowerPoint

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For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.

To learn more about the Montefiore Difference who we are at Montefiore and all that we have to offer our associates, please click .

Diversity, equity and inclusion are core values of Montefiore. We are committed to recruiting and creating an environment in which associates feel empowered to thrive and be their authentic selves through our inclusive culture.

We welcome your interest and invite you to join us.

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.

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