Medical Billing & Collections Audit Director

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<div class="isg-job-description“>About Rotech

Join a Leader in Home Healthcare

At Rotech Healthcare Inc., we’re more than a medical equipment provider-we’re a trusted partner in patient care. As a national leader in ventilators, oxygen therapy, sleep apnea treatment, wound care, diabetic solutions, and other home medical equipment, we empower patients to manage their health from the comfort of home.

With hundreds of locations across 45 states, our team delivers high-quality products, exceptional service, and compassionate support that helps patients live more comfortably, independently, and actively. Whether you’re a clinician, technician, or healthcare administrator, your work at Rotech directly improves lives.

Explore more about our mission and services at Rotech.com.

Overview and Responsibilities

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 Job Duties and Responsibilities

(Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.)

• 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
• 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
• Performs other duties as assigned

Qualifications

Employment is contingent on

• Background check (company-wide). Results will not be used automatically to disqualify individuals. Instead, the Company will conduct an individualized assessment that considers the duties of the position, the nature and timing of the offense, and any evidence of rehabilitation, in accordance with applicable laws.
• Drug screen (when applicable for the position)
• Compliance with healthcare facility credentialing process (when applicable for the position)
• Valid driver’s license in state of residence with a clean driving record (when applicable for the position)

Required education and/or experience

• High school diploma or GED equivalent, required

Preferred 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
• 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
• Payer knowledge; excellent payer knowledge and utilization of payer resources for decision making

Skills and Competencies

• Accurately perform simple mathematical calculations
• Effectively communicate in English; both oral and written
• Interpret a variety of communications (verbal, non-verbal, written, listening and visual)
• Maintain confidentiality, discretion and caution when handling sensitive information
• Multi-task along with attention to detail
• Self-motivation, organized, time-management and deductive problem solving skills
• Work independently and as part of a team

Machines, Equipment and Technical Abilities

• Email transmission and communication
• Internet navigation and research
• Microsoft applications; Outlook, Word and Excel
• Office equipment; fax machine, copier, printer, phone and computer and/or tablet

Physical Demands

• Lift and carry office equipment at times
• Requires sitting, walking, standing, talking and listening
• Requires close vision to small print on computer and/or tablet and paperwork

Rotech Information

Benefits

• Generous paid time off and paid holidays
• Overtime pay for non-exempt positions (as applicable)
• Commission for Account Executives
• Bonus and incentive opportunities
• Fixed and variable car reimbursement for Area Managers and Account Executives
• Car, mileage, and telephone reimbursement (as applicable)
• Employee discount and recognition programs

• Employee Assistance Program (EAP)

• 401(k), HSA, and FSA/Dependent Care FSA

• Medical, prescription, dental, and vision coverage

• 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

• Hepatitis B (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.

 

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