Medical Billing & Collections Audit Director

Rotech Healthcare Inc. is a national leader in providing ventilators, oxygen, sleep apnea treatment, wound care solutions, diabetic solutions and home medical equipment. We help patients lead a more comfortable and productive life by keeping them engaged in their care and empowering them to manage their health and treatment at home. Rotech provides high quality medical products, services and outstanding customer care through hundreds of locations across 45 states. For additional information, visit our company homepage Rotech.com

Summary

We are seeking a dedicated Medical Billing & Collections Audit Director. Responsible for overseeing and directing all audit team supervisors and support staff to ensure the efficient use of resources in accordance with audit policies and process flow in ways that consistently promote patient quality, employee satisfaction and accounts receivable management. Ensures that all practices are consistent with company ethics, standards and policies and procedures.

Essential Duties and Responsibilities

• Aggressively manages all non-compliance in a timely, complete and professional manner
• Analyze payer and process trends and outcomes through the use of Excel and other system resources
• Assist in internal and external audits and investigations (e.g. Compliance Audits, internal company audits and payer audits)
• Conducts employee counseling as needed for attendance, work performance and policy violations
• Directly responsible for interviews and hiring of best qualified candidates to maintain the budgeted staff of the audit team
• Ensures all productivity standards are met in a timely manner through measuring, monitoring and feedback
• Ensures all team members maintain full compliance with policy requirements
• Ensures audit staff are practicing safe work habits to ensure a safe work environment
• Ensures good communication with locations and auditors
• Gathers and analyzes information in order to provide recommendations on various issues
• Identifies team and individual training needs and assists in developing plans for immediate and long-term performance improvements
• Maintains up to date and accurate audit data and reports weekly to the executive team
• Manages difficult customer or employee situations; and responds promptly to customer or employee requests
• Monitors and documents employee performance and provides feedback to audit members, emphasizing continuous improvement
• Prioritizes and plans work activities of billing staff while striving to increase productivity and efficiencies
• Provides direction to audit staff and resolves problems in a timely and professional manner
• Reports Directly to the VP of Billing and Collections
• Responsible for maintaining audit documentation submitted for review and follow up at any time
• Responsible for properly communicating updated relevant changes and ensuring staff understands all relevant updates
• Reviews adjustment, related keying of audits and ensures all adjustments are approved in a timely fashion
• Reviews all applicable reports for accuracy and missing information and takes appropriate steps to audit, correct, reconcile and follow-up to completion and approval
• Reviews applicable audits for completeness, unusual items and charges and follows up on any discrepancies
• Works closely with the compliance and the executive team as it relates to the day to day processes and results of all audits received and submitted
• Works directly with the Fields' Sales Reps, Location Managers, AMs and RMs as it relates to Lawson audits and documentation gathering and training
• Performs other duties as assigned

Supervisory Responsibilities

• Manages all direct reports within their team by reviewing work-flow; inquiring about issues, delegating workload, ensuring work is being completed and communicating changes in requirements

Employment is contingent on

• Background investigation (company-wide)
• Drug screen (when applicable for the position)
• Valid driver's license in state of residence with a clean driving record (when applicable for the position)

Education and/or Experience

• A degree/certificate from an accredited school/college in healthcare or related field is preferred, or four years of equivalent combination of education and experience with previous management or supervisory experience in Durable Medical Equipment Prosthetics Orthotics & Supplies (DMEPOS) billing, collections and training will be considered for the minimum requirements of this position.
• Demonstrated leadership skills and management experience
• Knowledge of Medicare coverage/billing guidelines for DMEPOS is a must

Skills, Knowledge and Abilities

• Ability to determine root because analyses, create corrective action plans and results
• Department process knowledge; excellent knowledge of how the department processes are managed and monitored to achieve goals and productivity standards knowledge specific to the department managed and how it is used to make decisions
• Effectively communicate in English; both oral and written, with vendors, location employees and management to ensure questions and concerns are processed in a timely manner
• Helpful, knowledgeable and polite while maintaining a positive attitude
• Interprets a variety of instructions in a variety of communication mediums
• Knowledge of Durable Medical Equipment (DME) or Home Medical Equipment (HME)
• Maintain confidentiality and practice discretion and caution when handling sensitive information
• Multi-task along with attention to detail
• Must be able to accurately perform simple mathematical calculations using addition, subtraction, multiplication and division
• Payer knowledge; excellent payer knowledge and utilization of payer resources for decision making
• Self-motivation, organized, time-management and deductive problem solving skills
• System knowledge; excellent ability navigating systems and applications, specific to the department managed and how it is used to make decisions
• Work independently and as part of a team

Physical Demands

• Lift and carry up to 10 pounds
• Requires sitting, walking, standing, talking or listening
• Requires close vision to small print on computer and or paperwork
• Infrequent overnight travel may be required

Machines, Equipment and Technical Abilities

• Email transmission and communication
• Type on a computer and or a tablet
• Internet navigation and research
• Microsoft applications including but not limited to Word, Excel, Power-Point, Publisher, Access, etc.
• Office equipment; fax machine, copier, printer, phone and computer
• 12 key calculator
• IMBS system

Work Environment

• Office, call center environment

Benefits

• Generous paid time Off and paid holidays
• Overtime pay for non-exempt hourly positions based on business needs
• Commission for Account Executives
• Fixed and variable rate car reimbursement for Area Managers and Account Executives
• Employee discount program
• Employee recognition program
• Bonus and incentive opportunities
• Mileage reimbursement (when applicable for the position)
• Telephone reimbursement (when applicable for the position)
• EAP
• 401k
• Medical, Prescription, Dental and Vision
• HSA and FSA/Dependent Care FSA
• Life Insurance, Disability, Accidental death, Identity protection and Legal services
• Meru Health Mental health and Mercer SmartConnect Medicare programs
• Livongo Diabetes and High Blood Pressure programs
• Healthcare Bluebook and RX Savings solutions programs
• HEPB and TB vaccinations

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities. Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, gender identity, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees.