Compliance Pre-Billing Manager

Qualifications

• Education: Bachelor’s degree is required. Master’s or Juris Doctorate degree is preferred.
• Healthcare Compliance Certification required or within 6 months of assuming job.
• Experience: A minimum of 5 years’ experience in a healthcare organization, to include demonstrated leadership. Familiarity with COPs, LCDs, NCDs and state regulatory guidelines for all Charter service lines is a must.

Functions and Responsibilities

• Provide oversight and management of all billing audits.
• Oversight and tracking of all agencies pre-billed claims and maintain comprehensive information on the billing status and communication with the billing department.
• Facilitates the organization and reviews medical records and billing/claim information for each claim requested for Additional Documentation Review or other medical records requests.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Implements and maintains a system of management reporting that provides timely and relevant information on all aspects of audit and compliance issues.
• Develops and ensures efficient processes for documenting all compliance-related initiatives and activities.
• Establishes audit controls and procedures to monitor operational effectiveness and fiscal integrity.
• Provides guidance to management, medical staff, and individual departments so that clinical and other ancillary staff are aware of their responsibility for ensuring compliance with those areas.
• Fosters open lines of communication and exercises authority to apprise department heads of any issues of concern relating to compliance activities and procedures.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.
• Makes sure to monitor and analyze trends in disallowed claims and prepares reports as requested for agency leadership with additional training provided as needed.