Manager, Payor Policy & IQA

Lincare

Largo, FL

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JOB DETAILS

SKILLS

Analysis Skills, Billing, Contract Review, Data Collection, Data Processing, Electronic Medical Records, Federal Government, Fee Schedule, Government, Government Billing, Government Requirements, Internal Audit, Legal, Local Government, Mathematics, Medical Billing, Policy Development, Problem Solving Skills, Procedure Development, Project Tracking, Quality Assurance, Quality Management, Time Management, Workplace Issues

LOCATION

Largo, FL

POSTED

1 day ago

This employee manages multiple teams critical to the billing quality for all DME and Oxygen equipment, drugs, supplies, and services.

- Oversees payor contract updates in the EMR, ensures government payor updates are communicated and 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 with accuracy and in accordance with the CIA structure, as well as following all payor and state guidelines
- - Acts as SME for all payor policy-related topics as needed
  - - Works closely with Chief Compliance Officer on special projects as needed
    JOB FUNCTIONS
    - - Serves as the company-wide liaison for payor issues, works with Operations, billing offices, and payors to assist in resolving 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 in accordance 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 ensuring all state, federal, and local government billing requirements are met while working through the assigned projects
        Assists 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 centralized billing departments
        
        Education
        Associate's Degree or equivalent from two-year college or technical school, Preferred
        Work Experience
        2-3 years, 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 federal healthcare 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, and fundamentals of concepts such as fractions, percentages, ratios, and proportions to practical situations
        define problems, collect data, establish facts, and draw valid conclusions
        
        Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

About the Company

Lincare

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