Business Office Manager
3 weeks ago
We are seeking a highly skilled Business Office Manager to join our team at Siletz Tribal Gaming Comm. The successful candidate will be responsible for managing and supervising the day-to-day activities of the Business Office, Purchased/Referred Care, Medical Support, and Patient Accounts.
Key Responsibilities- Oversee the day-to-day operations of the clinic billing department and serve as onsite support for the billing company.
- Monitor, audit, and review compliance of third-party billing companies.
- Establish and monitor metrics for all aspects of the revenue cycle to improve KPI and research deviations of expected outcomes.
- Ensure all activities of the billing operations are conducted in a manner that is consistent with overall department protocol and in compliance with Federal, PRC, and third-party program rules, regulations, and procedures.
- Audit and test NextGen system enhancements.
- Audit patient accounts balances and prepare statement reports.
- Audit patient accounts for billing discrepancies compared to the insurance's ERA/EOB and make the appropriate corrections in that account as needed.
- Sign in as clinic EHR/EPM admin/super-user to add or update database information.
- Explain benefits and services covered by insurances and other third-party payers to patients and clinic providers.
- Assist and answer patient concerns with explanation of benefits (EOB's) and insurance denials.
- Prepare and analyze accounts receivable reports, weekly and monthly financial reports.
- Collect and compile accurate statistical reports.
- Analyze trends impacting charges, coding, collection, and accounts receivable. Take appropriate action to realign staff and revise policies and procedures.
- Associate's degree in Accounting or related field, and two years of progressively responsible experience in accounting or finance with 1 year supervisory experience -OR- an equivalent combination of education and/or experience.
- Knowledge of medical terminology, diagnosis, coding, and insurance terminology, preferred.
- Regulations related to Medicare, Medicaid, and commercial insurance.
- Medical billing procedures, preferred.
- Statistics to assess patient workload and establish quality controls.
- Electronic and manual billing, preferred.
- Continuous process improvement concepts and practices.
- ICD-10, CPT, HCPCS coding systems as well as professional claim forms such as CMS-1500 and UB-04 and billing practices.
- Advanced computer skills with specific knowledge of database, word processing, spreadsheets applications, EHR/EMR systems, and basic online billing and transmission procedures.
- Budget development and monitoring experience, preferred.
- Hiring, supervising, and performance reviews of team members.
- Tracking and auditing third-party and private payments.
We offer a competitive salary of $40.59 per hour and a comprehensive benefits package.
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