Medical Billing & Collections Audit Manager

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 and Collections Audit Manager to join our Billing team. In this position you are responsible for overseeing and directing Billing & Collection Center (BCC) Audit Supervisors and support staff on all Audits received for Rotech; 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.

Essential Duties and Responsibilities

• BCC Audit Managers must be up to date on qualifications of all order types for Audit
• Complete day-to-day BCC Audit operations and end of month processes
• Conducts general training of Audit of all Audit staff
• Directs staff on working all Audits received, report generation and Audit goals
• Implements Rotech's Audit policies, procedures and follows-ups to ensure consistency with policies and procedures
• Interacts with Medicare Auditors for Audit resolutions
• Oversees and manages the performance of BCC Audit staff to achieve the objectives of Rotech's Billing and Collection Center audit flow process, implementation of the process for audit of all accounts and goal setting
• Position supervises Billing & Collection Center (BCC) Audit staff and other positions deemed appropriate by BCC Audit Director; interviewing, hiring, and training employees; planning, assigning, directing work; appraising performance; rewarding and disciplining employees and addressing complaints and resolving problems as well as process improvements as applicable.
• Provides consistent communication of Audit and compliance information including policies and procedures to all staff
• Provides direction to staff regarding resolution of problematic issues and areas as well as general guidance on how to manage and prevent similar situations
• Remains current in changes through review of pertinent publications, pertinent DMERC workshops and self-study
• Reports directly to the BCC Director of audit at a minimum on a monthly basis, the status of any audits
• Reports quarterly to the BCC Divisional Director regarding any specific audit trends or issues
• Reports to Divisional Directors or Operations at their request for IMBS reports and audit trends related to field issues
• Utilize available mechanism (i.e. DMREC websites, internal and external newsletters, web boards, inter-company websites, etc.)
• Works with Operations and Sales Regional Managers, Location Managers and Compliance Specialist to prepare for Rotech on-site compliance audits
• Performs other duties as assigned

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 or certificate from an accredited school or college in healthcare or related field is preferred
• Two years 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 of this position
• Knowledge of Medicare Audit coverage/billing/audit guidelines for the DMEPOS, required
• Demonstrated leadership skills and management experience

Skills, Knowledge and Abilities

• Ability to determine Root Cause Analyses, create Corrective Action plans and results
• Ability to implement processes
• Ability to make effective presentations to management and employees with a high degree of professionalism and confidence
• Ability to write detailed reports, summaries and action plans
• Analyze payer and process trends and outcomes with Excel and other system resources
• Deductive reasoning skills
• Effectively communicate in English; both oral and written
• Interpret a variety of communications (verbal, non-verbal, written, listening and visual)
• Knowledgeable in federal payer program regulations and guidelines
• Maintain confidentiality, discretion and caution when handling sensitive information
• Multi-task along with attention to detail
• Overtime Management to BCC Goals
• Payer Knowledge; utilization of payer resources for decision-making
• Respond effectively to sensitive topics while creating and monitoring corrective action plans
• Self-motivation, organized, time-management and deductive problem solving skills
• SG & A Expense Management
• Staffing Levels; takes active role in interview and hiring process
• Voluntary turnover comparison to BCC Average
• Work independently and as part of a team
• Writes clearly and informatively; presents numerical data effectively

Physical Demands

• Lift and carry 50lbs during travel
• Lift and carry office equipment at times around the office
• Position requires overnight travel up to 10% of the time depending on business needs
• Requires close vision to small print on computer / tablet and or paperwork
• Requires sitting, walking, standing, talking or listening
• Travel via airplane and/or vehicle
• Utilize computer for extensive hours

Machines, Equipment and Technical Abilities

• Access/participate in Web based education
• Email transmission and communication
• IMBs system
• Internet navigation and research
• Microsoft applications; Word and Excel
• Office equipment; fax machine, copier, printer, phone and computer / tablet
• Remote access interface and communication
• Twelve key calculator

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.