Rehab Medical · 2 months ago
Director Payer Relations
Indianapolis, IN 46240, USA
Full-time
Onsite
Director/Executive
7+ years expRehab Medical is on a mission to transform lives through innovative custom mobility solutions. The Director of Payer Relations will serve as the primary liaison between the company and its payer partners, managing relationships, optimizing contracts, and ensuring accurate claims billing and reimbursement.
Health CareRehabilitation
Responsibilities
Establish and maintain successful contracting relationships with major payors such as United Healthcare, Aetna, Humana and BCBS
Lead the negotiation of payer contracts, including new agreements, renewals, and rate adjustments
Monitor and analyze payer fee schedules, reimbursement policies, and contract compliance
Collaborate with payers to resolve operational or claims processing issues that impact revenue cycle
Partner with the Revenue Cycle Director to ensure claims are submitted accurately, timely, and in compliance with payer rules
Work with the Director of Finance to validate reimbursement accuracy, identify underpayments, and escalate discrepancies
Oversee payer set-up in internal systems to ensure proper billing, coding, and contract application
Identify and implement process improvements to reduce denials, improve collections, and optimize cash flow
Develop and maintain strong working relationships with payer representatives to address claim denials, underpayments, and payment delays
Facilitate regular meetings with payers to resolve operational bottlenecks, compliance concerns, and policy misalignments
Act as an escalation point for unresolved payer issues impacting revenue recognition or patient care
Analyze trends in payer behavior, reimbursement, and policy changes to provide insights for company strategy
Partner with executive leadership to forecast financial impacts of contract terms and reimbursement changes
Educate internal teams on payer requirements, new contracts, and reimbursement methodologies
Support company growth initiatives by ensuring payer coverage aligns with expansion into new states or service lines
Qualification
Required
Bachelor's degree in Business, Finance, Healthcare Administration, or related field (Master's preferred)
Minimum of 7+ years of experience in payer relations, contracting, or reimbursement within the DME/CRT or healthcare industry
Strong knowledge of Medicare, Medicaid, and commercial payer policies, especially as they relate to DMEPOS and CRT
Proven experience in payer contract negotiations, rate setting, and dispute resolution
Deep understanding of revenue cycle operations including claims submission, denial management, and reimbursement analysis
Exceptional relationship management skills with the ability to collaborate across payers, internal teams, and executive leadership
Excellent analytical, communication, and negotiation skills
Familiarity with HCPCS coding, payer fee schedules, and CMS guidelines
Company
Rehab Medical
Rehab Medical takes pride in providing top of the line rehabilitative equipment.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Kenny Hicks
Chief Technology Officer
Michael Pahud
Chief Financial Officer
Company data provided by crunchbase