Mgr, Nat'l Payor Policy & QA

Lincare Holdings
United States, Florida, Largo
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