Healthcare Business Office Director Job Bellingham area,Washington USA,Healthcare

JOB SUMMARY:

The Healthcare Business Office Director will be responsible for day-to-day fiscal and administrative operations of the Business Office Department's billing and healthcare fiscal reimbursable divisions. This position will also serve as a main point of contact in communication with other Directors, Leadership, and other related programs exploring healthcare services that may be seeking potential revenue avenues. In addition to supervising Business Office Department Administrative Staff, in addition to services that include Coding, Billing, Accounts Receivable, Purchased & Referred Care (PRC), Tribal Assister Program and Healthcare Credentialing.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES include the following:

Administrative Duties:

Supervises the Healthcare Business Office Administrative Staff, including Purchased & Referred Care (PRC), Billing & Coding, Healthcare Credentialing, and Tribal Assister/Benefits Coordinator employees.

Works closely with Healthcare Department Directors and/or appropriate staff to:

Ensure clinical delivery services are billed appropriately and accurately.
Provides educational materials, forms, and fee schedules on proposed services.
Provides guidance and recommendations on current processes that may affect third party revenue.

Participate in staff and program meetings, which include consultation, supervision, and professional training sessions.

Works directly with patients to discuss issues and to find solutions that pertain to the Healthcare Business Office, including PRC, Tribal Assister Program, and Third-Party Billing.

Provides and develops training for Third Party Revenue, and Contract Health Services.

Assures that Business Office employees, Clinic, and Behavioral Health and Lummi Counseling Services employees are appropriately trained in accessing insurance portals, maintaining active logins, resetting logins, and training on how to use the portals. This is an important and critical part of third-party billing.

Works directly with patients and LIBC Health employees to discuss questions or concerns about their referrals, patient bills, and help guide patients through their insurance information to help educate the patient.

Studies and standardized procedures to improve efficiency of subordinates.

Develop, submit, and monitor operation budgets and expenditures.

Assures that best practices are observed consistently by staff through training, in-services, and specific direction; establishes or recommends new policies and procedures as necessary.

Works with the Lummi Indian Business Council, the Lummi Health & Family Services Commission, and other requested entities, as requested.

Regularly ensures payment for claim dues for pharmacy and clearinghouse submissions.

Coordinates and participates in Teams and Zoom meetings.

Submit JIRAs to communicate EPIC software needs to resolve issues, when needed.

Travel or participate in online relevant conferences, trainings, and meetings, when requested.

Reviews & approves timecards and time sheets in ADP.

Third Party Billing

Works closely with the Billing Supervisor, Coding Supervisor, Contracting & Reimbursement Supervisor, and Patient Registration staff to ensure collections of all third-party resources.

Schedules regular meetings for managers to discuss potential training needs or updates on new processes.
Participation in regular billing webinars affects changes to current billing standards.
Works as a team to establish productivity standards to maintain up to date billing standards.

Provides regular updates on data quality assurance within health programs for any changes to CMS rules and regulations to stay in compliance.

Analyzes information pertaining to the Business Office Department, and provides potential solutions with the guidance from Lummi's Office of the Reservation Attorney's Office for:

Establishing contracting guidelines with health insurance companies,
Establishing policy & procedures with any new implementation of Federal Laws that may pertain to Tribes, and
Reviewing any potential legal cases to protect Lummi Nation's best interest.

Shall efficiently follow guidelines for reporting as required by Federal, State, Local and…