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The Director of Follow-Up is accountable for payor accounts receivable (AR) performance, accelerating cash, reducing aged inventory, and improving denial and underpayment outcomes across government and commercial payors for the healthcare system. This leader oversees claim statusing, insurance follow-up, denials management, and underpayments/payment variance, and owns the payor follow-up operating model (work queues, prioritization rules, dispute/appeal pathways, and payor escalation governance, including Joint Operating Committees (JOCs)). The Director sets standard work, controls, escalation pathways, and performance targets/cadence, partnering with Revenue Integrity, Patient Access, Health Information Management (HIM), Coding, CDI, Managed Care, Finance, IT, and Compliance to reduce rework, prevent avoidable write-offs, and adapt to changing payor policies and regulatory requirements.
Qualifications
• Education: Bachelor’s degree in Healthcare Administration, Business Administration, Finance, Management, or a related field highly preferred. A formal degree may be substituted with 10+ years of direct, hands-on revenue cycle and supervisory experience managing hospital/professional billing and follow-up operations.
• Experience: Minimum of 5 years of progressive healthcare revenue cycle experience with a four-year degree.
• Minimum of 4 years of leadership experience managing hospital and/or professional billing operations with a four-year degree.
• Demonstrated experience with Epic and revenue cycle technologies.
• Proven success leading large teams through organizational change and process improvement initiatives.
• Epic Revenue Cycle Certification preferred.
• Deep knowledge of:
- Payor accounts receivable (A/R) workflows
- Claim adjudication processes
- Denial categories and root-cause analysis
- Follow-up best practices across government and commercial payors
• Proven track record of:
- Improving cash acceleration
- Reducing aged A/R
- Lowering avoidable denials
- Driving operational excellence through cross-functional partnerships
• Strong leadership skills with the ability to manage, develop, and motivate teams.
• Demonstrated performance management discipline, including:
- Key Performance Indicators (KPIs)
- Operational cadence
- Accountability measures
• Proven change leadership capabilities with a continuous improvement mindset.
• Excellent communication and interpersonal skills.
• Working knowledge of:
- Applicable federal and state regulations
- Healthcare compliance requirements
- HIPAA privacy principles
- Audit readiness and regulatory best practices.
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