Manager of Clinic Billing

JOB SUMMARY

The Manager of Clinic Billing is responsible for overseeing all aspects of the billing department to ensure accurate and timely revenue cycle management. The Manager of Clinic Billing will be responsible for ensuring high quality, timely completion of work, accurate claims processing, efficient processes, and positive working relationships among the supervised employees, internal and external customers. The Manager of Clinic Billing must regularly handle multiple responsibilities and deadlines.

ESSENTIAL DUTIES AND RESPONSIBILITIES

* Supervises and coordinates all functions of the revenue cycle of the Gerald L. Ignace Indian Health Center.

* Responsible for the creation, implementation, and maintenance of Business Office policies for all related programs, functions, services, and activities.

* Responsible for personnel management functions to include, but not limited to: completing annual employee performance reviews, processing leave requests, participation in the employee recruitment process, completing and issuing disciplinary actions.

* Provides technical assistance to management, clinic providers, patients and other personnel surrounding the work of the Business Office.

* Establishes and maintains a working relationship with Medicare and Medicaid intermediaries, state and federal agencies and third-party payors.

* Formulates and issues written instructions and procedures for non-routine or complex assignments, new or changed business office programs, functions, services, and activities.

* Responsible for working with clinical providers and billing staff to ensure capture of correct charges for services rendered to patients.

* Actively participates in performance improvement activities including, but not limited to: analyzing claims denial patterns.

* Work with HIT staff to ensure EHR system is optimized for the business office operations.

* Monitors productivity of all revenue cycle areas to ensure production standards are met. Promotes a positive work environment that emphasizes accuracy, efficiency and teamwork within the business office.

* Responsible for the completion and submission of business office center budgetary documents.

* Develops and updates procedural manuals as necessary. Keeps staff informed of changes in procedures, regulations and policies affecting the Business Office and its functions.

* The incumbent utilizes a number of substantive guidelines. Guidelines are provided and include the following: IHS circulars, Medicare and Medicaid newsletters and bulletins, State, Federal and

Public laws, HIPAA Guidelines, coding manuals, and other IHS procedure manuals. Applicable technical references are available from the private sector. The incumbent uses judgment in locating and selecting the most appropriate guidelines, references and procedures for application and in making appropriate changes to adapt to guidelines to specific cases.

* Ensures work is performed in compliance with the privacy act and the health insurance portability and accountability act (HIPAA) laws and regulations.

* Provide management with financial and business office operational reports with analytical narrative.

* Develops long and short range planning, evaluation, analysis, and projection in consultation with appropriate personnel including the Business Office Director.

* Performs other work-related duties as required or requested.

QUALIFICATIONS:

* Minimum five years of healthcare billing experience

* Must have a working knowledge of the International Classification of Diseases (ICD-9-CM, ICD-10-CM), Current Procedural Terminology (CPT) coding and medical terminology.

* Strong understanding of reimbursement policies and procedures as they pertain to third-party payors, intermediaries, and responsible parties.

* Problem solving.

* Ability to work independently and within a team environment.

* Ability to perform under pressure.

EDUCATION and/or SKILLS/KNOWLEDGE:

* Associates Degree in Healthcare Administration, Business Administration, Accounting, or related field.

* Experience in an FQHC or community health center desirable.

* Experience in EPIC Systems preferred.

* Must be English proficient.

* Must have strong interpersonal skills and strong organizational skills.

* Must have excellent verbal and written communication skills.

* Must have a working knowledge and proficiency in Microsoft Excel and Microsoft Word.

OTHER SIGNIFICANT FACTORS:

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. While performing the duties of this job, the employee is regularly required to sit; use hands to manipulate objects, tools or controls; reach with hands and arms; and talk and hear. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus. Noise level in the work environment is usually quiet.

Work is performed in an office environment utilizing various office equipment including, but not limited to, a computer, copy machine, fax machine, and multi-line phone. Ability to communicate effectively over the telephone, by computer and in person. Ability to perform well in a fast-paced work environment.

This is a general outline of the essential functions of this position and shall not be construed as an all-inclusive description of all work requirements and responsibilities. The employee may be required to perform other job-related duties as requested by the designated work leader(s). All requirements are subject to change over time. All positions at the Gerald L. Ignace Indian Health Center have the responsibility to carry out functions to maintain inspection and survey readiness, participate in Quality Improvement initiatives, as well as assist in and/or provide education for health promotion and disease prevention. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

Gerald L. Ignace Indian Health Center (GLIIHC) supports a safe, healthy and drug-free work environment through criminal and caregiver background checks and pre-employment drug testing. GLIIHC maintains a smoke-free environment.