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DIRECTOR REVENUE RECOVERY

BRONX, NY, US


The Director of Revenue Recovery assumes responsibility and accountability for managing initial denials for third-party payers, as well as vendor relationships. This includes overseeing the initial denial and recovery process used by both in-house staff and affiliated vendors, and continually working to identify opportunities for workflow and process improvements.  The Director, in conjunction with Senior Revenue Cycle leadership, sets goals, measures process effectiveness and productivity, and identifies any need for updated policies and procedures. The Director provides strategic vision and direction for the Initial Denials and Recovery Management program, with a focus on denial prevention.

 

Education/Skills:

Bachelor's Degree

 

Minimum Qualifications: 

EPIC certifications preferred. Lean Project Management experience preferred.
1. Five to seven years of progressive experience in appeal/denial management required.
2. Three to five years management experience required.
3. Strong knowledge of health plan requirements. 
4. Knowledge of EPIC enterprise system .
5. Knowledge of coding guidelines, both ICD-10 and CPT is preferred.  
6. Knowledge of federal, regional and state payer coverage patterns (CMS, fiscal intermediary, and Administrative Law Judge).
7. Excellent communication, leadership, organization and interpersonal skills required. 
8. Strong analytical and statistical analysis skills required and Microsoft Excel, Word and PowerPoint skills required.
9. Revenue cycle planning, implementation and evaluation of financial systems and procedures.
10. Ability to analyze and resolve problems; manage multiple priorities; prepare reports; organize, direct and evaluate work of assigned staff; utilize a variety of electronic software applications including hospital financial management systems; 
11. Initiative; tact; confidentiality; dependability; resourcefulness

 

Department: Revenue Cycle Bargaining Unit: Non Union Campus: TARRYTOWN  Employment Status: Regular Full-Time Address: 1 Fordham Plaza, Bronx
Shift: Day Scheduled Hours: 8 AM-4:30 PM Req ID: 192116 

 

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. 

 

N/A 


Mission:
To heal, to teach, to discover and to advance the health of the communities we serve.

Vision:
To be a premier academic medical center that transforms health and enriches lives.

Values
Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

  • Humanity
  • Innovation
  • Teamwork
  • Diversity
  • Equity