Director of Provider Relations

Job Summary

A company is looking for a Director of Provider Relations - Bill Review.

Key Responsibilities

• Lead and support a team of Provider Account Managers, setting goals and development plans
• Oversee operations for provider account management, ensuring timely responses to inquiries and disputes
• Manage strategic claim-level negotiations and ensure compliance with billing standards

Required Qualifications

• 5+ years of experience in provider relations, claims negotiation, or payment integrity
• 2+ years of experience in people management or team leadership
• Experience in itemized bill review and payment integrity
• Familiarity with Medicare Advantage billing and reimbursement rules
• Strong knowledge of medical coding and payment methodologies