ESSENTIAL FUNCTIONS AND BASIC DUTIES: Supervisory-Specific Performance Expectations, Duties, and Responsibilities: o Demonstrates 100% commitment to high perfonnance in accordance with the CHOICE values ofMRH and represents the organization in a positive and professional manner. o Provide direct supervision to the billing staff, ensuring perfonnance expectations are met, including training and onboarding of new staff to ensure proficiency in the billing processes. o Foster a collaborative and accountable work environment. o Conduct regular staff meetings to communication updates, policies, and goals. o Develop training programs to ensure staff remains current on billing regulations, payer policies, and claim submission best practices. o Conduct employe evaluations, bi-weekly timesheet approvals, and attend monthly management meetings. Position-Specific Performance Expectations, Duties, and Responsibilities: o Oversee the accurate and timely submission of claims for inpatient, outpatient, and professional services. o Ensure compliance with healthcare regulations, including HIPPA, CMS guidelines, and other relevant laws and standards. o Stay updated on changes in healthcare regulations and payer requirements that impact the revenue cycle. o Analyze denials, implement corrective actions, and oversee the appeals process to maximize reimbursement. o Review and correct claim edits to ensure compliance with payer regulations while minimizing denials and billing errors. o Collaborate with departments such as Registration, Coding, and Finance to develop and implement process improvements. o Ensure timely management of old and/or uncollectible accounts including bad debt with regular reviews, appropriate write-offs, and implementation of strategies to minimize future occurrences. o Member of the RAC team. Must have a general understanding of the RAC program. The team establishes proc Compliance Officer on Revenue Cycle related issues as requested. o Conducts internal audits pertaining to work queue management. Review and evaluate results. Make recommendations based on these results to improve revenue, workflows and/or compliance regulations. o Identify opportunities to optimize revenue capture and minimize revenue leakage. o Conduct and review audits on current denials to detennine root causes and identify patterns or trends. o Provide monthly detailed reporting statistics to the Revenue Cycle Director and CFO on K.Pls. o Demonstrates a professional, positive and caring attitude. .,. o Works closely with other departments, including, but not limited to registration, prior authorization, and coding. o Performs other duties as assigned. Organization-Specific Performance Expectations, Duties, and Responsibilities: o Demonstrates 100% commitment to performance in accordance with the CHOICE values ofMRH and representing the organization in a positive and professional manner. o Establishes and maintains effective verbal and written communication and good working relationships with all patients, staff, and vendors. o Adheres to MRH attire/dress code per policies and procedures. o Utilizes initiative; strives to maintain a steady level of productivity; self-motivated; and manages activity and time. o Completes annual education, training, in-service, and licensure/certification requirements; and attends departmental and organizational staff meetings or reads meeting minutes. o Maintains patient confidentiality at all times. o Reports to work on time as scheduled; completes work within designated timeframes. o Actively participates in departmental and organizational performance improvement and continuous quality improvement activities. o Strives to uphold regulatory requirements to ensure continual compliance with departmental, hospital, state, and federal regulations and policies. o Follows policies and procedures for infection control, safety, and risk management to ensure a safe environment for patients, the public, and staff.[QUALIFICATIONS:
Minimum Requirements: o Must be at least 16 years ofage (21 for driving positions with a valid driver's license). o Must be able to legally work in the United States. o Must be able to pass a background check. o Must be able to pass a drug screen and breath alcohol test (if applicable). o Must complete employee health meeting. o Excellent analytical, organizational, and communication skills. o Extensive knowledge in CAH and RHC billing and coding practices. Required Education/Licensure/Certification: o Bachelor's Degree in Healthcare Administration, Finance, Accounting, or a related field required. o Minimum of 5 years of experience in healthcare revenue cycle auditing, billing, coding, or related field required. o Proficiency in Microsoft Excel required. o Minimum of2 years of experience in a Critical Access Hospital and Rural Health Clinic Revenue Cycle role. o Strong leadership, problem-solving, and communication skills with the ability to manage a team effectively required. Experience: o Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification preferred. o Proficiency in EPIC preferred. o Strong understanding of UB-04 and CMS-1500 claim forms required.Position Classification:
Non-Exempt
Compensation Range: $41.86 to $62.78
Benefits: Medical, Dental, Life, Retirement, Paid Time Off
Visual Requirements X
Auditory Requirements X
