Revenue Cycle Director

2 weeks ago

Tucson, United States Catholic Community Services of Southern Arizona Inc Full time
Job DescriptionJob Description

Catholic Community Services of Southern Arizona, Inc. (CCS) is thriving For 90 years, CCS has focused its mission to strengthen families, support communities, provide compassionate services, and deliver excellence. Providing Help. Creating Hope. Serving All.

We credit our continued success to our valuable employees If you want to make a difference, help people, and serve your community, we want YOU to join our team For more information visit our website at: www.ccs-soaz.org.

OVERVIEW

Under direction of the Chief Financial Officer, manages and monitors the processing of medical billing claims and invoices, posting payments, and the correction and resubmission of denied claims or invoices in behavioral health program. Position includes oversight of medical records in compliance with HIPAA and federal and Arizona state laws; the billing and benefits enrollment screening process, including front and back office operations; enrollment into organization programs; and financial screenings. Position may from time to time be stressful and require a high demand of performance. May perform other duties as assigned.

ESSENTIAL FUNCTIONS

  • Supervise and manage the daily activities of supervisees, including: interviewing, hiring, training, professional development, evaluations, and terminations
  • Oversee and support Billing Specialist activities, including: billing, insurance verification, charge capture, collections, and development and implementation of billing procedures to ensure timely and complete collection of revenue
  • Oversee the data validation process to ensure submission of error-free claims for processing and payment
  • Oversee the resubmission of claims as necessary
  • Direct and assist with processing and adjudicating claims; posting payments; monitoring claims, denials, and appeals for efficient processing; and resolving billing-related issues both with health insurance plans and with Electronic Health Record (EHR) vendor
  • Maintain medical billing spreadsheets
  • Develop and implement short and long-range revenue cycle processes for the benefit of the organization and its members
  • Communicate with management regarding front end user errors and issues that are impacting the revenue cycle
  • Coordinates with Compliance representative to ensure high level of ethics, accuracy, transparency, and accountability to agency programs
  • Resolve and answer help desk tickets related to billing
  • Complete month end revenue reporting tasks
  • Liaison with revenue cycle vendors, including CCS' EHR vendor, and health insurance plans and to coordinate billing activities and resolve issues
  • Ensure compliance with and support of Executive directives, contracts, and established policies and procedures, as well as federal and state regulations
  • May drive personal or agency vehicle on company business
  • May perform other duties as assigned

MINIMUM REQUIREMENTS

Suitable work experience may be considered as transferable skills in order to meet minimum requirements of the position and will be considered by the Executive Director of Human Resources.

  • Bachelor Degree in Business Administration, Finance, or related
  • 2 years of experience supervising and overseeing medical billing, data validation, and claims submission and resubmission (preferably behavioral health)
  • 2 years of experience working in medical billing, data validation, and claims submission and resubmission (preferably behavioral health)
  • Proven skills utilizing Microsoft Office Suite
  • Ability to obtain First Aid and CPR certification
  • Proven strong communication skills - oral and written are clear, concise, and in an organized fashion using appropriate style, grammar, and tone

REGULATORY

  • Must be at least 18 years of age
  • Valid driver license, proof of insurance, and 39-month motor vehicle report
  • Ability to obtain and maintain Arizona Level One Fingerprint Clearance Card and FBI National Criminal Records History Report (employer paid)
  • Pass pre-employment drug screen (incudes marijuana, regardless of recreational use laws) (employer paid)

DESIRED QUALIFICATIONS

  • Master Degree in Business Administration, Finance, or related
  • Billing and/or coding certification and/or credential
  • Additional years of directly-related experience
  • Behavioral health work experience
  • Experience working with Arizona Medicaid providers in relation to billing
  • Bilingual in English and Spanish, verbal and written

The above statement reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered a detailed description of all work requirements that may be inherent in the job.

We are an Affirmative Action Equal Opportunity Employer for all individuals. All qualified applicants are encouraged to apply.

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