Responsible for the day-to-day operations related to all revenue cycle functions, with a focus on customer service, quality improvement, and stewardship.
Essential Duties and Responsibilitiesinclude the following.
- Support the organizations mission and goals, quality standards, and patient-centered medical home philosophy. Embrace KANAs culture of serving the whole person through our provision of services. Incorporate KANAs core values ofCourtesy, Caring, Respect, Sharing, and Pridein all activities and decisions.
- Uphold KANAs Code of Ethics by conducting professional activities with honesty, integrity, respect, fairness, and good faith in a manner that reflects positively upon the organization.
- Ensure effective and efficient daily operation of departments related to the revenue cycle with a focus on achieving optimal reimbursement without sacrificing patient satisfaction or care. Demonstrate and maintain effective working relationships with staff and other internal and external customers.
- Serve as the liaison between KANA and the billing contractor. Define and maintain procedures that lead to continuous process improvement of the revenue cycle in coordination with the billing contractor.
- Schedule and attend meeting with billing contractor at least twice a month.
- Work closely with program manager to develop and improve revenue generating mechanisms.
- Develop and maintain Key Performance Indicators for the revenue cycle. Report KPIs to Finance Director monthly.
- Annually review KANA fee schedule and make changes as appropriate. Collaborate with Finance Director and other Directors prior to making changes.
- Attend conferences as requested by supervisor.
- Collaborate with Finance Director to review and negotiate payor contracts on behalf of KANA.
- Work closely with program managers to develop and improve revenue generating mechanisms.
- Audit and monitor accuracy of information entered into billing and health records databases, including sliding fee scale applications with supporting documentation, coding and data entry, patient identifying information, EHR table maintenance, insurance information, payment posting and denials through quality assurance projects.
- Periodically review and update the sliding fee scale, prompt pay, and self-pay policies and schedules to ensure each continues to meet the objectives of the organization. Share changes with Patient Access Manager for implementation.
- Collaborate with Credentialing Specialist and Health Administration Manager to ensure all Providers are enrolled with third party payers to ensure timely and compliant billing.
- Demonstrate through daily interactions with staff, patients, leadership and peers, commitment to exemplary customer service, continuous quality improvement and stewardship initiatives.
- Observe, identify, recommend then evaluate methods to ensure effective and efficient use of staff, facilities, equipment, and other resources while maintaining exceptional customer service standards.
- Identify gaps in customer service, patient and work flows, billing impediments and patient relations, working with team members and leadership to resolve any identified problems.
- Perform all managerial duties related to staff selection, training and evaluation.
- Hold one on one meetings with direct reports weekly at a minimum.
- Conduct staff meetings quarterly, or more frequently as needed, ensuring the team has been scheduled and completed all required work-related training sessions. Schedule in several sessions as necessary to ensure coverage.
Supervisory Responsibilities:Directly supervises Billing and Insurance staff and other support staff as assigned. Carries out supervisory responsibilities in accordance with the organization's policies following the mandates or guidelines established by all relevant regulatory agencies. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; processing timesheets; appraising performance; rewarding and disciplining employees; addressing complaints and conflicts.
Requirements
Bachelors degree in Healthcare Administration, or a related field. Masters degree preferred. Minimum three (3) years experience in managing health care delivery systems. Experience working in a rapidly changing and innovative healthcare system. Strong background in financial management and knowledgeable of all applicable laws, regulatory requirements, and best practice guidelines relating to healthcare management.
This Employer is an Equal Opportunity Employment (EOE) employer exercising Native preference in accordance with P.L. 93.638
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