Assistant Healthcare Administrator

SUMMARY

This position is responsible for the day-to-day billing and revenue cycle processes with attention to billing outcomes and coding performance. This includes working with the billing company, department staff and Physicians to ensure optimum billing performance and for overseeing billing for the Medical and Dental Clinics and to resolve their billing and revenue cycle problems. This position will oversee the billing teams that manage accounts, communication will insurance company, collections, payment posting, billing transactions and report creation. Ensure that these areas run smoothly and detect any problems in the billing system and correct them accordingly. The position is very computer intensive and must have knowledge of MS Office Suite, knowledge of GTB accounting billing system and general search engine skills are a must. The Assistant Healthcare Administrator is responsible for maintaining and securing all written and electronic medical records within the clinic. They will also ensure that information contained in the record is complete, accurate and only available to authorized personnel. They will also be responsible for ensuring that the clinic meets the required standards to be successful in managing medical records.

MINIMUM QUALIFICATIONS

• Bachelor's Degree in Business Administration or Finance* or equivalent related experience.
• Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare.
• Two (2) to three (3) years' progressively and successful management experience preferred.
• Thorough knowledge of medical terminology, anatomy, physiology, disease processes, medical record science, computer applications in medical records and current dynamics in the health care industry.
• Up to date with health information technologies and applications
• Must have a valid unrestricted driver license and be insurable by the GTB insurance carrier.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Manage the day-to-day billing operations within the department with emphasis on front end systems to ensure that all information provided to billing company is accurate and billed in a timely fashion.
• Includes the registration, scheduling, co-pay collection, self-pay collection and system set up issues.
• Responsible for denial management, collaborating with staff to ensure claims processing occurs in a timely manner.
• Review Provider notes to ensure that all services rendered are billed properly.
• Responsible for coding review and oversight for ensuring accurate reimbursement for services billed.
• Responsible for driving process improvement initiatives related to front end revenue cycle functions in collaboration with billing company, clinic staff and Health Director.
• Identify opportunities for work process improvements with respect to claim denials.
• Works with staff on strategies to improve front end related issues.
• Provide feedback to the Providers on coding errors for both procedure and E&M services
• Verifies that fee schedules are appropriate against insurance payer's allowable fees.
• Facilitates and influences the credentialing process to assure prompt ability to bill for services rendered by newly hired Physicians.
• Reviews EOB's as needed to determine / address payer problems.
• Coordinates efforts regarding authorization issues.
• Preparation of analytical reports.
• Must complete the Medicare Cost Report.
• Develop solutions to billing related to patients and/or insurance
• Manager should be proficient with basic computer programs such as the Microsoft Office suite.
• Ensure accuracy and completeness of billing information.
• Create and process documentation related to billing.
• Oversee billing process and work with others to resolve issues.
• Make sure that medical coding used is in compliance with all medical coding laws and regulations and ensure that the coding used is for reimbursable expenses when necessary.
• Responsible for communicating with patients regarding rejected claims or procedures, so effective communication skills are necessary.
• Responsible for operations of patient business services, insurance verification.
• Identify revenue cycle problems and implement solutions for improvement.
• Maintain confidentiality and stay current on changes to insurance coding (especially Medicare).
• Protect the security of records to ensure that confidentiality is maintained.
• Identify, compile and code patient data, using current ICD, CPT and other standard classification coding systems.
• Ensure data entry of Provider information entered into the State Medicaid and Medicare systems are entered timely and correctly.
• Set up Providers in the current EHR system, and ensure access is granted for system use for patient documentation.
• Ability to set goals and priorities.
• Make recommendations for department policies, and programs.
• Assist Healthcare Administrator with program management of Medical and Dental Clinics
• The Assistant Healthcare Administrator assist with the development, implementation, and monitoring of fiscal year department budgets, preparing reports.
• Assist with monitoring patient satisfaction to ensure that they are positive. Reviews patient questions, as appropriate, recommends and/or implements corrective actions as identified
• Assist in the preparation of annual budgets, and other Program Director duties.
• Maintain patient confidentiality as per Health Insurance Portability and Accountability Act (HIPAA) of 1996 and complete HIPAA compliance training.
• Other duties as assigned by Healthcare Administrator.

OTHER SKILLS AND ABILITIES

• Must have excellent verbal and written communication skills.
• Must have excellent interpersonal skills with demonstrated patience, tact and respect.
• Must have exceptional detail and follow-up skills.
• Must have proven proficiency in computers, including Microsoft Windows Operating System and Microsoft Office Suite and the Resource Patient Management System (RPMS).
• Skill in developing, implementing, and administering work processes.
• Detail oriented and tolerant of frequent interruptions and distractions from patients and staff.
• Effectively communicate with physicians, patients, insurers, colleagues and staff.
• Oversee billing, and accounts, ensuring accuracy and that company procedures are followed.
• Conduct analysis to understand growth and revenue drivers and motivations.

EDUCATION and/or EXPERIENCE

• Bachelor's Degree in Business Administration or Finance* or equivalent relevant work experience.
• Must have thorough knowledge of Medicare and Medicaid.
• Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare.
• Two (2) to three (3) years' progressively and successful management experience preferred.
• Thorough knowledge of medical terminology, anatomy, physiology, disease processes, medical record science, computer applications in medical records and current dynamics in the health care industry.
• Up to date with health information technologies and applications

OTHER QUALIFICATIONS

• Certified professional coder preferred or willing to obtain training.
• Program Director Training certified or to take the training.
• Must have a working knowledge of CPT and ICD9 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, insurance benefits and appeal processes.

DRIVING REQUIREMENTS

• Must have a valid unrestricted driver license and be insurable by the GTB insurance carrier.
• Must be willing to travel for continued training and education.

SUPERVISORY RESPONSIBILITIES

Responsible for the direct supervision of the Health Clinic billing and medical records staff.

EQUIPMENT TO BE USED

Standard office equipment including desk computers, laptop, calculators, printers, fax machine, telephone systems, etc.

TYPICAL PHYSICAL DEMANDS

Work requires sitting, lifting, reaching, walking, and lifting heavy objects, such as a case of paper or several books at once. Also requires manual dexterity to operate office equipment, keyboarding, copiers, etc.

TYPICAL MENTAL DEMANDS

The complexity and responsibility inherent in this position requires performance with above average ability, calmly and decisively in response to the demands of the position. Work requires close attention to task for work to be accurately completed and be able to use judgment to respond to events several times a week. Medical coding aspect requires a high level of repetition that can be mentally draining

WORKING CONDITIONS

A good deal of work is performed in an office environment, but it is important to realize that some of the work is on the floor and in the other offices.

COMMENTS

Native American Preference will apply. Must be willing and able to pass a background investigation and a drug and alcohol urinalysis as a condition of employment. Adherence to strict company policy regarding confidentiality is a must

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Management retains the right to add or to change the duties of the position at any time through approved motion by Tribal Council. * Any qualifications to be considered as equivalents in lieu of stated minimums require prior approval of the Director of Human Resources.

Current Openings for Assistant Healthcare Administrator Jobs at Grand Traverse Band of Ottawa and Chippewa Indians