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Manager of Hospital Billing Compliance Audits
2 months ago
Billing Audit Manager for Healthcare Facilities
Location: The ideal candidate will reside within a reasonable distance from one of our key operational sites and will engage in a hybrid work arrangement (1-2 days per week in the office).
Company Overview: As a vital part of the DirectEmployers network, we are dedicated to optimizing payment integrity and minimizing unnecessary healthcare expenditures.
Position Overview: The Billing Audit Manager plays a crucial role in ensuring the effective execution of various cross-functional initiatives through collaboration with functional leaders. Responsibilities may encompass cultural transformation, strategic planning, process enhancement, change management, and quality improvement initiatives.
Key Responsibilities:
1. Define the scope and design of programs/projects.
2. Facilitate the identification of necessary deliverables and validate return on investment (ROI).
3. Establish a framework for ongoing program monitoring.
4. Develop metrics and reporting tools for program/project evaluation.
5. Analyze discrepancies in relation to the program/project plan.
6. Lead the creation of documentation to support business objectives and ensure alignment.
7. Advocate for local stakeholders and strategic decision-makers.
8. Recruit, train, mentor, and assess the performance of team members.
Minimum Qualifications:
A Bachelor's degree and a minimum of 5 years of experience in project/program management, process reengineering, organizational design, or implementation; or any combination of education and experience that would provide an equivalent background.
Preferred Qualifications:
Registered Nurse with an active license is highly desirable.
Experience in conducting Hospital Bill Audits, including the comparison of itemized bills/UB04 to medical records, is strongly preferred.
Experience with vendors specializing in Hospital Bill Audits or Itemized Bill Reviews is advantageous.
Experience collaborating with Payment Integrity vendors that perform audits on behalf of payers is preferred.
Travel to various work sites and locations may be required.
For candidates working in person or remotely, the salary range for this specific position is competitive and commensurate with experience.
Benefits:
In addition to a competitive salary, DirectEmployers offers a comprehensive benefits package, including incentive programs, stock purchase options, and 401k contributions (subject to eligibility requirements).
The salary offered for this position is determined based on a variety of legitimate, non-discriminatory factors established by the company.
DirectEmployers is committed to ensuring equitable pay opportunities for all employees, regardless of gender, race, or any other protected category under federal, state, and local pay equity laws.
