1 day old
2018-01-222018-02-21

Supervisor, Healthcare Billing Recovery Quality Assurance

Performant Financial
Sunrise, FL
  • Job Code
    2017-50-7-016
Performant Financial Corporation

Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

Supervisor, Healthcare Billing Recovery Quality Assurance
Job Code:2017-50-7-016
Location:Sunrise, FL
Status:Regular Full Time
  
Responsibilities:
Performant is a market leader that delivers analytics, audit and recovery services for healthcare, government and student loans.  We’re more than brick and mortar – we are about helping people. It’s a dynamic, fast-paced and fun workplace like a start-up, but with the backing of a profitable public company with a history of growth.

We are looking for skilled hands-on manager with expertise in Medical Billing Recovery, knowledge of Coordination of Benefits and Third-Party Liability (COB/TPL), Medicare Secondary Payer (MSP) claims involving Group Health Plan (GHP) and Non-Group Health Plan (NGHP), coupled with experience in quality assurance programs and staff to ensure operational adherence to policies and procedures, contract and regulatory requirements.   

As the Healthcare Billing Recovery Quality Assurance Supervisor you will be lead efforts to develop and maintain Quality Assurance program infrastructure, and a team of Healthcare Billing Quality Specialists performing audit activity to validate compliance with internal requirements, client contracts, regulatory requirements, and industry quality standards. 

• Serve as “Quality Officer” for Company’s MSP operations.
• Lead Quality function to ensure company compliance with departmental, company, regulatory and client requirements and SLAs.
• Develop/update policies, procedures, tools, training, and reporting to be followed by the team. Proactively own the continuous improvement of the function. 
• Ensure team is qualified and scalable to client contract demands & meeting any/all deadlines, and resolution to client matters and issues. Hire, train, and manage staff effectively.
• Ensure team is accountable for following company policies, procedures and requirements, as well as managing staff in accordance with management requirements, work volume, and budgetary requirement.
• Maintain depth of knowledge on applicable client contract(s) and alignment with operational leaders to ensure QA function meets requirements, is aligned with SOPs, and supports program optimization. 
• Conduct assessments to ensure that operations teams across all business lines are complying with contracts, regulations, and policies. 
•Develop and provide written reports containing audit/review results 
• Present audit/review results to applicable operational leadership and teams.
• As directed, work with other Performant Corporation departments and divisions to assist with documentation of policies and procedures and conducting quality assessments, recommended changes and updates to work instructions as needed to document changes to client or regulatory requirements, to create efficiency and/or best practices. 
• Support initiatives for obtaining and/or maintaining quality certifications such as ISO and CMMI, as well as applicable internal or external audit activities for such certifications.
• Participate in various projects as assigned by management. 
• May be required to work some Performant holidays due to client requirement.
• Perform other incidentals and related duties as required and assigned.
 
Required Skills and Knowledge:
To perform this job successfully, an individual must be able to perform each essential function satisfactorily.
Below are representative of the knowledge, skills, and abilities required. 

• Able to review and analyze reports and information from disparate sources and form logical conclusions and applicable functional requirements.
• Strong written and verbal communication skills ability to communicate with all levels within the organization and external clients.
• Strong knowledge of concepts, practices, terminology, regulations and procedures for Healthcare Billing Recovery, Revenue Cycle Management and/or Medicare Secondary Payer. 
• Working knowledge of quality certifications and related infrastructure such as ISO/CMMI.
• Possess ability to lead in a team environment where collaboration to solve problems, generate solutions and the knowledge transfer process are critical for success. 
• Strong analytical and critical thinking abilities.
• Ability to deal well with ambiguity; effectively shift gears comfortably; comfortable handling risk and adversity. 
• Demonstrates excellent judgment; anticipates consequences of actions and weighing multiple, sometimes conflicting, priorities. 
• Acts with confidence, makes good decisions in the best interest of the company and drive results given direction in the form of assigned goals or objectives. 
• Able to solve complex problems, and resolve disagreements with informed, rational debate. 
• Mind-set of continuous improvement, learns and adapts quickly to change; impact positively in a fast-paced and dynamic environment.
• Strong supervisory skills - provides feedback, coaches and trains staff.
• Good project management skills with experience managing multiple projects, as well as direct and indirect resources concurrently. 
• Able to maintain confidentiality of sensitive data. 
• Comprehensive computer skills; skilled at operating/utilizing MSOffice applications to include Excel, Word, PowerPoint, and ability to quickly learn new proprietary and client applications.
• Solid understanding of data systems and account workflow systems.

Physical Requirements:
• Job is in a busy standard office environment with moderate noise level, sits at a desk during office hours, uses office phone system; views a computer monitor, types on a keyboard and uses a mouse.  
• Sit approximately 85% of the day. 
• Stand/walk approximately 15% of the day. 
• Occasionally lift/carry/push/pull up to 10lbs. 
• Consistently viewing a computer screen and keyboard frequently up to 75% of time. 
• Communicates frequently on the phone with internal resources; head-set may be provided upon request. 
 
Education and Experience:
• Bachelor’s Degree in Business, Management, Information Systems, Finance, or related (or equivalent combination of education and experience).
• 5+ years of hands on supervisory of medical billing recovery, and/or quality operations of the same (Medicare Secondary Payer experience preferred). 
• 5+ years of progressive relevant experience in the healthcare/medical billing industry.
• Experience overseeing or contribution to establishing audit policy and procedures; experience establishing or maintaining quality certifications a plus.  
• Experience evaluating and restructuring workflow and procedures, involving cross-functional activities and systems. 
• Experience reviewing contractual, regulatory, and procedural documents, and leveraging to develop and execute assessment tools, criteria and reporting.  
• Experience in role with similar scope of responsibilities, with proven track record. 


Other requirements:
- Must submit to and pass pre-hire background check, as well as additional checks throughout employment.
- Must not have any current defaulted student loans.
- Must not have any Federal or State liens resulting from County, State or Federal tax issues.
- Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors.
- Must submit to and pass drug screen.

Performant is a government contractor. Certain client assignments for this position may require submission to and successful outcome of additional background and/or clearances throughout employment with the Company.

Visa sponsorship is not available.

Job Profile is subject to change at any time.

EEO 
Performant Financial Corporation is an Equal Opportunity Employer. 
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. 

NO AGENCY SUBMISSIONS WITHOUT PERFORMANT AUTHORIZED AGENCY AGREEMENT AND APPROVED PERFORMANT JOB ORDER
 
  

Categories

  • Government
  • Information Technology
  • Legal
  • Management
  • Healthcare

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Supervisor, Healthcare Billing Recovery Quality Assurance

Performant Financial
Sunrise, FL

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Performant Financial
Sunrise, FL

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