Director, Customer Payer Services - CPS

JOB SUMMARY: 

The Director, Customer Payer Services (Third Party Reimbursement), is responsible for the overall leadership and direction of the Home Care and Extended Care referral intake and billing operations.  The associated Hill-Rom product lines include support surfaces, bed frames and related products.  This leader reports to the Executive Director of Finance for Post-Acute Care and is part of the Home Care business leadership team including the VP Sales, VP Marketing, Chief Compliance Officer, etc.  This person is required to provide exceptional cross functional leadership working with multiple areas including Sales, Field Service, Information Technology, Accounts Receivable, Compliance, etc. to drive business results

ESSENTIAL DUTIES AND RESPONSIBILITIES – Other duties may be assigned:

• Lead the referral intake and billing for Home Care and Extended Care 3rd Party transactions


• Utilize a robust set of performance metrics to manage the operations


• Drive process improvement including use of Six Sigma and related data analysis tools. 


• Benchmarking of key operating metrics is required on an ongoing basis (credits as a % of revenue, cost to collect, etc.)


• Support the growth of the business as reimbursement pressures increase


• Drive world class compliance processes working with the CPS team and with the Compliance department and others in the organization.


• Establish influence and credibility with the sales force, marketing teams and other areas of Hill-Rom


• Ensure organization development of all levels of the CPS organization


• Provide frequent and meaningful communication to the business leaders and all levels of the CPS team

SUPERVISORY RESPONSIBILITIES:

Position has nine direct reports covering the referral intake and billing areas as well as process improvement and an administrative assistant.  Total associates in the department are currently in excess of 100.  

QUALIFICATIONS:

Required

• BS/BA or equivalent experience


• At least 15 years background in medical claims processing, well versed in industry benchmarks


• Experience leading a large team of associates


• Full and complete understanding of revenue cycle processes


• Strong understanding and experience dealing with claims processing computer systems and related IT issues (e.g., document imaging)


• In-depth operational experience with third party payers (Medicare, Medicaid and Insurance) and their processes


• Exceptional leadership and ability to create an effective connection between sales, marketing, service, accounts receivable, etc.


• Formal training in process and productivity improvement


• Excellent oral & written interpersonal skills


• Capable of energizing employees to embrace customer needs and remove barriers to business success


• Organized and results oriented with a proven track record of delivering results

Preferred

• Six Sigma Training


• MBA


• DME Experience