Revenue Cyle Manager Indian Community

JOB TITLE

Revenue Cyle Manager

Lower Sioux Health Care Center

Health Services Director

Lower Sioux Health Care Clinic

Non
- Exempt / Fulltime

Monday – Friday 8:00am to 5:00 pm, may occasionally require evenings and weekends.

Dependent on Experience

The Revenue Cycle Manager is responsible for managing the timely and accurate submission of LSIC claims to third party payers and the management of rejected claims. Collaborates with the LSIC Finance team to do predictive financial modeling for all LSIC program strategic initiatives.

• Bachelor’s degree in business or related field required with three (3) to five (5) years’ experience with third party payment, claims submission and management, and ICD-10 coding. Master’s degree preferred.
• Registered Health Information Administrator (RHIA) preferred
• Three (3) to five (5) years of supervisory experience and background in business office management, preferably in a medical clinic required.
• Demonstrated understanding of MS Office, electronic billing software and related software programs.
• Demonstrated understanding of LSIC policies and procedures for coding, billing and the management of the related processes that comply with state and federal compliance.
• Demonstrated understanding of all third-party claims’ submission processes.
• Working knowledge of ICD-10 and CPT/HCPC’s coding to interpret and manage claims in a timely and accurate manner.
• Demonstrated ability to establish and maintain relationships with the third-party payer community and related stakeholders to ensure resolution of outstanding claims.
• Demonstrated ability to analyze complex medical record documentation and identify and submit for billable services.
• Exceptional organizational skills and experience with database management.
• Ability to gather data, compile information and prepare reports to meet regulatory compliance.
• Ability to maintain strict confidentiality of patients, medical, clinic and LSIC information.
• Knowledge and experience working with Native American communities, culture, customs, and tribal public health preferred.
• Must have current driver’s license, reliable personal transportation, proof of current insurance coverage, and insurability under the tribe’s auto insurance policy.
• Any employment offer is contingent on results of a drug and alcohol test and a health care background check as required by Centers for Medicare Services, as a condition of obtaining employment.
• American Indian/Alaska Native preference applies to equally qualified candidates.
• Must pass background checks allowing the individual to work in a Minnesota health care facility.

• Leads staff in the timely and efficient billing and management of third-party claims.
• Monitors the status and progress of work, make day-to-day adjustments in accordance with established priorities.
• Instruct employees in specific tasks and job techniques and make available written instruction, reference materials and supplies. Ensuring that required policies and procedures and regulations are being implemented and managed.
• Provides orientation for new employees, manages performance and identifies training needs for employees.
• Responsible for the timely and accurate submission of claims to third party payers and intermediaries.
• Responsible for management of rejected claims.
• Reviews reports to identify claim trends and mitigate any delays in submission or payment. Communicates all claims unbillable, along with reason and makes recommendations for mitigation of future trends.
• Documents all activity performed on patient accounts in the billing system.
• Responsible for maintaining currency in third party payer trends, legislation and regulations.
• Demonstrated ability to understand and implement applicable Federal, State and Tribal regulations and statutes.
• Provides guidance and leadership to department staff in the interpretation of denials, codes and other information necessary to expedite billing third party payers.
• Actively participates in department meetings, committees and conferences.
• Actively participates in the financial analysis of all strategic…