RN Director - Medical Bill Auditor Team

This role can be filled in ANY Zenith Branch

This role is eligible to participate in Zenith’s hybrid work schedule which provides the flexibility to work from home on select days of the week according to the in-office schedule established by regional executive leadership. Selected candidate must be able to report into an office on a weekly basis.

The Medical Auditor Team (MAT) Director will direct and manage MAT staff in accordance with organizational expectations, ensuring that operations are effective, appropriate, timely, and compliant with internal and external expectations while ensuring compliance with regulatory and/or statutory jurisdictional requirements.

The essential functions of this position include, but are not limited to, the following:

• Direct and manage MAT team, including timely resolution of the team's workload.
• Oversee the recruiting and interviewing process for the MAT staff across all branches.
• Conduct required performance evaluation process for the MAT staff.
• Further develop team for succession planning and business continuity.
• Assure that the MAT team adheres to all Zenith policies and procedures.
• Ensure compliance with regulatory, license, and jurisdictional requirements for all reporting staff.
• Train MAT nurses on improving efficiency and accuracy using different systems.
• Provide continued development and innovation of products and services offered by MAT.
• Refine how MAT collaborates with other departments such as Claims, SIU, and nurse consultants.
• Determine ways to measure or observe success in partnership with Bill Review and Claims.
• Create a repository of historical negotiated rates with rehab facilities.
• Identify coding and billing schemes as well as opportunities for growth and innovation.
• Monitor trends around FL per diem rates and identify and solve for any questionable behavior.
• Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
• Work productively and harmoniously with others on a consistent basis.
• Respond positively to direction and feedback on performance.
• Consistently maintain professional and appropriate demeanor.
• Perform other duties/projects as assigned.

Education Qualifications

• High School Diploma or equivalent training/experience required
• Associate’s Degree from accredited nursing school required
• Bachelor’s Degree BSN preferred

Experience Qualifications

• 7 Years relevant coding and bill auditing experience required
• 7 Years management experience required
• Clinical experience required

Skills and Abilities

• Excellent negotiation, problem solving and analytical skills and strategies. 
• Excellent communication skills. 
• Proven ability to plan and perform involved or technical work presenting new or regularly changing problems, work from broad instruction, deal with complex factors not easily evaluated required. 
• Excellent interpersonal skills with proven ability to develop and maintain effective vendor and business partner relationships at all levels of the organization, influence decisions and collaborate effectively across the organization required. 
• Outstanding oral, written and formal presentation skills including ability to communicate complex ideas with all levels of the organization required. 
• Proven ability to manage multiple tasks and adapt to a changing, fact paced environment, detailed oriented with strong organization skills required. 
• Must possess strong leadership skills in the areas of motivation, coaching, personal development and change management. 

Licenses and Certifications

• Certified Professional Coder (CPC) required
• RN - Registered Nurse required

The expected salary range for this position is $110,938.85 to $138,673.57. Actual pay will be adjusted based on experience, geographic location, and other job-related factors as permitted by law.

Qualifications may warrant placement in a different job level.

Benefits

• Medical, Dental and Vision Insurance
• Flexible Spending Accounts
• Paid Parental Leave
• Life, AD&D and Disability Insurance
• 401(k), Employee Share Purchase Plan (ESPP)
• Education and Training Reimbursement
• Paid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave
• 10 paid Company Holidays, 2 Personal Days, 2 Floating Holidays
• Employee Assistance Program (EAP)
• For more information, review details on the Benefits page of our Career Site: https://www.thezenith.com/careers/benefits/

Zenith typically posts jobs for a minimum of 8 to 14 calendar days. If you are interested in any of our open positions, we encourage you to submit your application promptly.

Zenith Insurance Company is an equal opportunity employer and considers all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristic. In compliance with California law, we are committed to fair hiring practices. Pursuant to the California Fair Chance Act (AB 1008), we will consider qualified applicants with criminal histories in a manner consistent with the law. Additionally, in accordance with the Los Angeles Fair Chance Initiative for Hiring Ordinance, we will not inquire about an applicant’s criminal history until after a conditional offer of employment has been made.

If you are a qualified individual with a disability or a disabled veteran and need assistance accessing our career center or applying for a position due to your disability, you are entitled to request an accommodation. To make a request, please contact a Human resources representative at Zenith Insurance Company.

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Salary : $110,939 - $138,674