Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client's needs and tailoring innovative healthcare cost management solutions.

Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talent individual can participate and perform their best work.

We are MultiPlan and we are where bright people come to shine!

JOB SUMMARY: This role leads a team of dedicated clinical operations professionals tasked with assuring the smooth and efficient daily operations of the department. The incumbent utilizes operational expertise in the provision of analysis of the highest dollar and most complex claims to ensure correct billing practices are applied. This driven incumbent will develop and execute regular review processes in an effort to identify deviations from quality and accuracy standards while working to ensure processes executed remain fully compliant with established standards.

JOB SCOPE: This position works under limited supervision in a self-directed and results oriented manner. The role will challenge the incumbent to play a key role in the strategic direction of the department. The incumbent follows established procedures and utilizes knowledge of the company's general business principles, industry dynamics, market trends, and specific operational details when performing all aspects of the position. This is a people management job with authority for all HR actions (hiring, separations, discipline, training, etc.).

** The salary range for this position is 80,000-95,000. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

JOB REQUIREMENTS (Education, Experience, and Training):

• Minimum high school diploma and 5 years' experience in direct patient care, medical procedure billing, medical insurance auditing, line item review, audits, coding and/or reimbursement; 2 years' supervisory experience is also strongly preferred. Bachelor's degree in healthcare, business, or a related field in a plus.

• Coding certification required through American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC)

• Extensive knowledge of inpatient/outpatient hospital billing including UB-04s, revenue codes, itemization of charges, CPT codes, HCPCS codes, ICD-9/10 diagnoses and procedure codes, DRG, APCs.

• Knowledge of payer reimbursement policies, state and federal regulations, medical necessity criteria and applicable industry standards.

• Knowledge of commonly used medical data resources such as MDR, Medical Fees in the US, etc.

• Knowledge of medical terminology, anatomy, and physiology

• Preferred: Auditing and health information management experience in a healthcare setting

• Experience with professional and facility contract interpretation.

• Experience and proficiency using MS Office Suites: Excel, Outlook and PowerPoint, Visio helpful.

• Excellent communication (written, verbal and listening), interpersonal, organizational, time-management, analytical, problem-solving, trouble-shooting, customer service skills.

• Ability to read and abstract medical records.

• Ability to develop educational materials and job aids pertaining to coding and claims.

• Ability to work evening and weekend hours as needed to meet deadlines.

• Ability to handle multiple tasks in a fast-paced environment.

• Ability to meet individual and team goals, deadlines and work standards.

• Ability to apply independent judgment and determine appropriate course of action.

• Ability to interact and discuss results with providers.

• Ability to lead, teach, mentor others, and facilitate a learning environment.

• Ability to process detailed verbal and written instructions

• Ability to work independently and handle confidential information

• Ability to adjust/alter workflow to meet deadlines

• Ability to work with accuracy in a fast-paced environment

• Ability to display professionalism by having a positive demeanor, proper telephone etiquette and using proper language and tone.

• Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone.

BENEFITS

We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.

Your benefits will include:

• Medical, dental and vision coverage with low deductible & copay
• Life insurance
• Short and long-term disability
• 401(k) + match
• Generous Paid Time Off
• Paid company holidays
• Tuition reimbursement
• Flexible Spending Account
• Employee Assistance Program
• Summer Hours

EEO STATEMENT

MultiPlan is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here.