Also referred to as:
Director of Third Party Reimbursements, Provider and Claims Reimbursement Services Director
Requirements and Responsibilities
Reimbursement Services Director directs claim reimbursement activities to facilitate accurate, timely, and compliant operations. Oversees managers and supervisors responsible for reimbursement processing, recovery, and reconciliation functions. Being a Reimbursement Services Director establishes and monitors procedures for filing reimbursement claims. Provides technical oversight to ensure claim activities adhere to regulatory standards, requirements, and guidelines. Additionally, Reimbursement Services Director develops processes and controls to verify policy details, validate charges and coding, and ensure claim accuracy and completeness. Analyzes reimbursement trends, financial data, and performance metrics to drive continuous improvement. Remains knowledgeable of payer policies, regulatory reporting requirements, and financial objectives. Requires a bachelor's degree. Typically reports to senior management. The Reimbursement Services Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Reimbursement Services Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function.
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