Director of Reimbursement and Billing Operations

6 days ago


San Francisco, California, United States Element Science Full time
About the Role

We are seeking a highly experienced and skilled Senior Director to lead our Revenue Cycle Management operations at Element Science. As a key member of our team, you will be responsible for setting comprehensive reimbursement strategic direction, implementing systems, and driving the execution of revenue cycle processes and compliance with all healthcare regulations to optimize financial outcomes.

Key Responsibilities
  • Reimbursement Strategy Development: Develop and execute reimbursement strategies to optimize revenue cycle management and ensure compliance with regulatory requirements, including assessment of build vs outsourcing strategies.
  • Billing Process Development & Management: Implement best practices for billing operations, system implementations, and continually assess and improve processes.
  • Regulatory Compliance: Stay current on federal and state regulations related to reimbursement and billing for durable medical equipment.
  • Cross-Functional Collaboration: Partner with Payer Relations and Market Access team and IT team to implement reimbursement processing steps such as EDI submissions as CMS and each Payer are contracted.
  • Team Leadership: Build and lead a high-performing reimbursement and billing team.
Requirements
  • Bachelor's degree in healthcare administration, business, or related field; Master's degree preferred.
  • Minimum of 15 years of experience in healthcare reimbursement and billing, with at least 7 years in a leadership role.
  • In-depth knowledge of Medicare, Medicaid, and commercial payer reimbursement policies for durable medical equipment.
  • Strong understanding of healthcare compliance and regulatory requirements.
  • Proven ability to develop and implement successful reimbursement strategies, processes, and systems.
  • Excellent leadership, communication, and interpersonal skills.


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