Billing Audit Manager
2 weeks ago
Billing Audit Manager - Healthcare Operations
Location: The preferred 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 member of the DirectEmployers family, we are committed to optimizing healthcare expenditure through innovative solutions and integrity in payment processes.
Role Overview: The Billing Audit Manager plays a crucial role in the success of various cross-departmental initiatives by collaborating with functional leaders. Responsibilities may encompass cultural transformation, strategic planning, process enhancement, change management, and quality assurance 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 ongoing monitoring processes for program progress.
4. Develop metrics and reporting tools for program/project evaluation.
5. Analyze deviations from the program/project plan.
6. Lead the creation of documentation to support business objectives and ensure consistency.
7. Act as a champion for local stakeholders and tactical 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, specifically comparing itemized bills/UB04 to medical records, is strongly preferred.
Experience with vendors that perform Hospital Bill Audits or Itemized Bill Reviews is desired.
Experience working with a Payment Integrity vendor that conducts audits on behalf of payers is preferred.
Willingness to travel to various work sites as necessary.
For candidates working in person or remotely, the salary range for this position is competitive and commensurate with experience.
Compensation and Benefits:
In addition to a competitive salary, DirectEmployers offers a comprehensive benefits package, including incentive programs, equity stock purchase options, and 401k contributions (subject to eligibility requirements).
The compensation for this position is determined based on various legitimate, non-discriminatory factors set by the company.
DirectEmployers is committed to ensuring equitable pay opportunities for all employees.
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