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Mgr, Nat'l Payor Policy & QA

Lincare Holdings
United States, Florida, Seminole
8040 Bryan Dairy Road (Show on map)
Jul 02, 2026
The Mgr, Nat'l Payor Policy & QA manages multiple teams critical to the billing quality for all DME and Oxygen equipment, drugs, supplies, andservices.


  • Oversees payor contract updates in the EMR
  • ensures government payor updates are communicatedand implemented in a timely and effective manner
  • oversees special projects related to billing quality
  • manages internal billing quality assurance reviews
  • ensures that projects and assigned tasks are completed timely withaccuracy and in accordance with the CIA structure
  • follows all payor and state guidelines
  • Acts asSME for all payor policy-related topics as needed
  • Works closely with Chief Compliance Officer on special projectsas needed


JOB FUNCTIONS


  • Serves as the company-wide liaison for payor issues

    • works with Operations, billing offices, and payors to assist inresolving payor issues/concerns that arise


  • Oversees the Vent Queue Team
  • Oversees the contract review team to ensure that payor contracts are being reviewed timely and accurately inaccordance to the guidelines set in place
  • Oversees company-wide assigned projects and assignments
  • Works with applicable departments to ensure that changes in policies are being addressed timely
  • Monitors and maintains all payor relationships, enassuring all state, federal, and local government billingrequirements are met while working through the assigned projects
  • Assist with writing and developing of policies and procedures
  • Liaison for any CIA and internal audits
  • Manages internal monthly and ad hoc billing quality reviews, overseeing the review process, data collection,delivering results and education
  • Assists in identifying areas that need to be reworked or addressed
  • Resolves employee issues as they apply
  • Delivers directives from the Corporate office as they apply
  • Communicates with Executives, Legal, Compliance, and any applicable parties pertaining to the billingdepartments
  • Travel required once per quarter

Education


  • Associate'sDegreeor equivalent from two-year college or technical school, Preferred


Work Experience


  • 2-3 years related, Required


Knowledge, Skills, and Abilities


  • read, analyze, and interpret general business periodicals, professional journals, technical procedures or correspondence, payor contracts, fee schedules, and policies, state and federalhealthcare billing guidelines, and procedure manuals
  • effectively present information and respond to questions from groups of managers, clients,vendors, Executives, and other stakeholders
  • work with and apply mathematical concepts such as probability and statistical inference, andfundamentals of concepts such as fractions, percentages, ratios, and proportions to practicalsituations
  • define problems, collect data, establish facts, and draw valid conclusions

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