Director of Reimbursement

Position Summary:

Are you looking for a full-time opportunity with an established company located in Grand Rapids? Are you looking for the next step in your career? We are looking for an experienced healthcare billing manager to take that next step and be considered for a Director of Reimbursement position. Under the direction of the Managing Director, this position oversees the back-end revenue cycle functions of the Accounts Receivable, Cash and Patient Services teams. This role is responsible for developing, implementing and maintaining standard operating procedures; developing, monitoring and assessing business metrics in order to refine processes and improve efficiencies; establishing internal goals and identifying external benchmarks.  We are looking for someone who brings unique perspectives and experiences to our team, demonstrates strong leadership skills, is curious and asks questions, enjoys problem-solving, and strives to continually grow and improve.

As a Director of Reimbursement at Medical Management Specialists, you would have the following roles in operations:

  • Build, plan, organize and provide direction and oversight for back end revenue cycle functions including payment posting, exception follow up and resolution, accounts receivable and denial management, and patient and payer customer service.
  • Analyze payer reimbursement data to look for trends, summarize findings and make recommendations to leadership.  Identify front end versus back end issues. 
  • Monitor and report on key performance indicators on a regular basis.
  • Assist with review of new payer agreements.
  • Maintain current fee schedules by payer for each client and review payment variances for each on a regular interval.
  • Identify and address potential revenue enhancement opportunities by collaborating with cross-functional teams and multiple departments.
  • Monitor changes in payer reimbursement and recommend strategies and workflow enhancements to ensure accurate reimbursement for clients.
  • Involvement in recruitment, performance monitoring, retention, and disciplinary action in consultation with Human Resource and leadership team.

We expect candidates for this role to meet the following qualifications:

  • Excellent leadership, verbal and oral communication skills.
  • Strategic minded with an ability to collaborate with leadership to proactively navigate the changing healthcare environment.
  • Microsoft Office: Excel, Outlook, Word, PowerPoint.
  • Extensive knowledge of healthcare billing and policies and regulatory requirements.
  • Knowledge of claim submission, ICD-10 and health care insurance reimbursement.
  • Knowledge and expertise of the appeals process with various insurance carriers.
  • Familiarity with healthcare documentation in order to pursue timely and accurate reimbursement.
  • Ability to manage appeal activities to successfully overturn denied or incorrectly paid claims.
  • Excellent ability to understand and interpret statistical reports and perform quantitative analysis.

Other qualifications:

  • Bachelor’s Degree in Health Care Administration, Business Administration or related field.
  • Minimum of 5 years medical revenue cycle or reimbursement experience, including 1 – 3 years of management experience.  Revenue Integrity related experience strongly preferred.
  • Coding knowledge and billing enrollment/credentialing experience is preferred.
  • Knowledge of medical billing software required, MedFM preferred.
  • Team Player.
  • Excellent leadership, verbal and oral communication skills.
  • Strategic minded with an ability to collaborate with leadership to proactively navigate the changing healthcare environment.

Medical Management Specialists is a medical billing company that provides a full range of services to Emergency Medicine, Urgent Care and Anesthesiology.

We have been a part of the West Michigan medical community for over 20 years. We offer a great working environment, competitive salary, and an excellent benefits package.  If you are interested in being part of a creative and innovative culture, please submit your cover letter and resume as a statement of interest.                    

MMS is an equal opportunity employer.
Job Type: Full-time
Job Location: Grand Rapids, MI

For immediate and confidential consideration, interested candidates can apply by completely filling out our secure application form.

How to Apply

Medical Management Specialists offers a competitive salary and exceptional benefits package.  Interested candidates can apply by completely filling out this secure form.  

You may also send your CV and expectations by fax to 616-285-0842 or mail to:

Attn: Human Resources
4100 Embassy Dr. SE
Suite 200
Grand Rapids, MI 49546