Medical Billing & Claims Manager (DHPI98)

Tuba City Regional Health Care • Tuba City, AZ

86d

About The Position

The purpose of the position is to manage and lead the medical, pharmacy and dental billing of third-party payers applicable to outpatient, inpatient, ancillary, ambulatory surgery and professional services. Incumbent is responsible for management, providing technical direction and submission of properly executed claims in a timely manner to third party payers, responsible parties, and resubmission of corrected claims. Maximize reimbursement and minimize denied payments. Understand and monitor Patient Financial Key Performance Indicators while achieving the Clean Claim Goal established for TCRHCC. Responsibilities will also include delegation and assistance to the Director of Revenue Cycle.

Requirements

• Associate degree in Business Administration or related business field.
• Minimum three-years of successful supervisory or management experience.
• Minimum five-year experience as a medical billing technician in a tribal or non-profit healthcare patient accounting.
• Demonstrated knowledge of ICD-10, and CPT/HCPCS coding/billing procedures.
• Ability to access and use multiple data systems.
• Obtain a Certification as a Revenue Cycle Representative through the Healthcare Financial Management Association (HFMA) within one year from date of hire.

Nice To Haves

• Positive working relationships with others.
• Possession of high ethical standards and no history of complaints.
• Reliable and dependable; reports to work as scheduled without excessive absences.
• Ability to plan and lead effective team meetings and training.
• Possess expertise in professional communication, interpersonal, organizational leadership and team building skills.
• Possess excellent customer service skills for internal and external customers.
• Ability to work under pressure and make quality and effective decisions.
• Ability to positively motivate individuals and teams to meet or exceed department expectations/goals.

Responsibilities

• Manage and lead the billing functions and staff in the medical (Institutional & Professional), Pharmacy and Dental billing.
• Develop, implement and maintain billing policies and procedures.
• Establish and maintain a working relationship with Medicare and Medicaid intermediaries, state and federal agencies, area employers and private insurance.
• Provide technical assistance to management, medical providers, patients and other facility personnel regarding medical billing requirements.
• Coordinate and oversee work of staff; distribute workloads as necessary.
• Monitor productivity of staff to ensure it meets production standards.
• Train employees and hold periodic in-house training sessions.
• Prepare and conduct employee job performance evaluations.
• Assist with testing of new software and implementation of new payer requirements.
• Verify accuracy of services and billed amounts.
• Provide monthly reports and organize schedules.
• Attend and participate in management meetings.
• Ensure proper PPE is worn while on duty.
• Perform other duties and special projects as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Ambulatory Health Care Services
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees