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Kirby Bates Associates is pleased to announce an exciting engagement opportunity for an Interim Senior Director of Payment Operations. As a nationally recognized healthcare leadership firm, we are seeking a strategic leader to oversee end-to-end provider payment management. The Interim Senior Director will be the primary architect of payment integrity, ensuring seamless recovery and reconciliation efforts to recoup funds for our clients. This is a critical role for an expert who thrives at the intersection of operational excellence and financial accuracy within the TPA space.
Job Responsibility:
Manage the full lifecycle of provider payments, including complex recovery and reconciliation workflows
Lead multidisciplinary teams to drive innovation and achieve high-performance results in payment processing
Ensure all processes align with healthcare regulations, payment integrity principles, and cost containment strategies
Oversee EDI standard processes (ANSI 835), client billing, and stop-loss systems
Direct recoupment processes and handle complex interest calculations, particularly for non-ERISA plans
Requirements:
Bachelor’s degree in Accounting, Finance, Healthcare Administration, or a related field (Master’s degree preferred)
10+ years of healthcare payment operations experience
Specific experience in the TPA space is essential, specifically with organizations that directly issue provider payments rather than routing through traditional carriers
Deep understanding of EDI standard processes (ANSI 835), remittance advice, stop-loss systems, and capitation payments
Proven track record of managing multidisciplinary teams and fostering a culture of innovation
Strong grasp of healthcare regulations and payment integrity/cost containment principles
What we offer:
Attractive compensation package including housing, transportation, and regular travel home