Position Overview:

The Payer Reimbursement Supervisor is responsible for overseeing the day-to-day operations of the Payer Reimbursement team, ensuring the accurate interpretation of payer contracts, timely reconciliation of payments, and the optimization of payer performance across all surgical hospital facilities. This role serves as a key liaison between internal teams, payers, and leadership, providing direction, support, and oversight of analysts within the department. The ideal candidate brings strong leadership skills, in-depth knowledge of managed care reimbursement, and a commitment to operational excellence.

Key Responsibilities:

• Supervise daily activities of the Payer Reimbursement team, ensuring timely and accurate execution of contract analysis, reconciliation, and payment validation tasks.
• Monitor team productivity and quality metrics; provide coaching, performance feedback, and development opportunities.
• Oversee the reconciliation of bank deposits and resolution of unapplied cash issues; ensure discrepancies are addressed promptly.
• Collaborate with payers and internal stakeholders to resolve complex payment variances, missing remittances, and contract compliance concerns.
• Lead training efforts for new hires and provide ongoing education on payer-specific guidelines and portal functionality.
• Develop and implement process improvements to enhance reimbursement accuracy, workflow efficiency, and data reporting.
• Maintain an updated library of payer documentation, contract terms, and reimbursement policies; ensure accessibility for all stakeholders.
• Track and report on payer performance trends; escalate recurring issues and recommend corrective action to leadership.
• Ensure compliance with Medicare LCDs and monitor private payer policy changes that impact surgical hospital reimbursement.
• Assist in developing reimbursement strategies and aligning department objectives with broader revenue cycle goals.
• Support special projects and initiatives, including payer audits, new system implementations, and reimbursement optimization efforts.

Qualifications:

• 5+ years of experience in payer reimbursement or revenue cycle management, preferably within a surgical hospital or ASC setting.
• 2+ years of supervisory or team lead experience with proven ability to manage and motivate staff.
• Strong understanding of managed care contracts, payer guidelines, and reimbursement methodologies.
• Experience with cash reconciliation, contract administration, and payment analysis.
• Excellent problem-solving skills and the ability to manage competing priorities in a fast-paced environment.
• Strong interpersonal and communication skills with the ability to build relationships across departments and with external payers.
• Advanced proficiency in Microsoft Excel, Word, Outlook, and PowerPoint.
• Familiarity with healthcare financial systems and payer portals.
• Bachelor’s degree in Healthcare Administration, Finance, Business, or related field preferred; equivalent work experience considered.