Performant Manager, Healthcare Billing Recovery Operations in Sunrise, Florida
Manager, Healthcare Billing Recovery Operations
Status:Regular Full Time
A Career Opportunity for the motivated high performer looking for more than just a job! 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. As a Healthcare Billing Recovery Operations Manager you will be responsible for day-to-day oversight for a team of Case Workers performing billing recovery services for our clients. •Applies subject matter expertise to developing and employing practices and teams that meet and exceed client requirements; may serve as named resource and practice lead for specific business segment, or client business type. •Plans and collaborates to ensure appropriate staffing levels and staff competencies for assigned business •Contribute to development and continuous improvement of operational tools, processes and procedures. •Ensure assigned team consistently achieves established metrics and goals assigned, quality and compliance requirements. •Leads by example and demonstrates Performant core values in performance of job duties and all interactions. •Provides feedback, coaching and additional training to assigned team to correct areas of deficiency and oversight received from quality reviews and/or management, as well as performance feedback and skills development to increase capability and effectiveness of specialists. •Oversee work activities and provide guidance for case and call escalation. •Builds, manages and developments effective teams, which may be composed of leads, first level supervisors, professionals and agent staff members that are both exempt and non-exempt. •Maintains professional and technical knowledge, including staying current with industry policy by tracking emerging trends in healthcare commercial billing recovery. •Builds HCS value and credibility internally and externally, and represents the organization in meetings with the client, provider organizations, contractors, subcontractors and vendors. •Uses excellent communication skills in order to influence a wide range of internal and external audiences. •Timely response to escalated inquiries from the client and providers. •Support other departments in problem resolution as necessary. •Inspires trust and credibility- delivers on commitments Other Duties •Performs other duties as 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: •Demonstrated ability to lead and drive operational results in similar healthcare billing recovery or insurance claim review function. Leverages operational reports and data to evaluate team results and identify areas for improvement. •Depth and breadth of Knowledge and experience with medical claim billing recovery, auditing, billing procedures, medical terminology and medical coding; preferably in a role generating, auditing, recovery and/or researching the same involving Worker’s Compensation, Auto Liability and other non-group health plan primary payer liabilities. •Experience with Coordination of Benefits and Medicare Secondary Payer involving Group Health Plan (GHP) and Non-Group Health Plan (NGHP) Third Parties. •Proven expertise in gather and interpret Explanation of Benefits (EOB) to answer questions and resolve medical billing issues, including Medicare and Medicaid claims. •Strong professional communicator, verbal and written, that is effective with management, staff, client and vendor representatives, providers, carriers, beneficiaries and other audiences regarding claims and billing payment. •Protected patients’ privacy, understands and adheres to HIPAA standards and regulations. •Remarkable interpersonal and communication skills; ability to listen, be succinct and demonstrate positive customer service and servant leadership attitude. •Ability to share knowledge and educate staff and third parties on healthcare billing and claims related terminology, procedures, and related information. •Ability to establish and maintain effective work relationships internally and externally at all levels, and influence effectively. •Proven experience in developing and managing high performing dynamic teams. •Strong critical thinking, analytical and problem-solving skills. •Self-motivated and thrives in a fast-paced office environment performing multiple tasks cohesively, with keen attention to detail. •Proficiency using standard office technology; computer, various applications and navigation of on-line tools and resources, keyboard, mouse, phone, headset. •Ability to apply knowledge learned in training from various forms (memos, classroom training, on-line training, meetings, discussions, etc.). •Proven ability to effectively manage and develop staff and teams. •Demonstrated success leading and collaborating on improvement of process, procedures and workflow. •Ability to effectively perform deliver results, and work cooperatively with others to promote a positive team environment. •Ability to adapt quickly and transition effectively to changing circumstances, client requirements, assignments, and business needs; and consistently performs job responsibilities. •Ability to work full-time on-site and as needed to meet business needs. •Possess a personality type that is ethical, friendly, hard-working and proactive. Physical Requirements Job is in a busy standard office environment with moderate noise level, sits at a desk during scheduled shift, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a mouse. Reads and comprehends information in electronic (computer) or paper form (written/printed). •Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment •Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts •Consistently communicates on the phone with account holders, may dial manually when need or use dialer system; head-set is also provided •Occasionally lift/carry/push/pull up to 10lbs.
Education and Experience:
•Minimum 2 years of experience as a supervisor/manager for similar function. •Minimum 8 years of experience in medical billing reclamation or recovery, or audit/QA of the same demonstrating depth of knowledge and capability required for the position. •High School diploma or GED required •Some college in business/management or medical terminology, billing, coding or Medical Billing/Coding certification preferred. Other Requirements Must submit to and pass background check. Must not have any Federal or State liens resulting from County, State or Federal tax issues. Must not have any current defaulted student loans. Must be able to pass a criminal background checks; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment lists. Must submit to and pass drug screen. Performant is a government contractor. Certain client assignments for this position may require additional background and/or clearances. Job Profile is subject to change at any time. 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.