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Title

Business Office Manager 

Description

Job Summary

Oversees the day to day activities of multiple functions within Yellowhawk’s business office. Responsible for registration, patient billing and collection, third-party payer relations, and preparation of insurance claims. Ensures activities comply with Yellowhawk’s standards and government regulations. Generates billing reports and other reports. Manages subordinate staff in the day-to-day performance of their jobs. Ensures that program milestones/goals are met and adhering to approved budgets. Incumbent has extensive knowledge of business office processes. All duties and responsibilities will be performed in accordance with the Yellowhawk Mission and Vision statements.

Essential Job Functions

  1. Provides day-to-day oversight to all operations of the Business Office, including supervision of staff, monitoring of daily activities, and the quality and quantity of work produced.
  2. Responsible for oversight of all aspects of Third Party revenue collections, Compliance, Coding and Purchased Referred Care (PRC).
  3. Responsible for all billing credentialing application processes.
  4. Responsible for oversight of Assistant Business Office Manager (Outstation Outreach Workers and Tribal Navigator), Eligibility/Compliance Supervisor (Eligibility Coordinators and Referral Coordinators), Coders, Accounts Receivable/Third Party Biller and Purchased Referred Care Supervisor (PRC Clerks).
  5. Responsible for administrative duties related to eligibility software (i.e. MMIS, One-Health Port, etc.)
  6. Responsible to provide revenue supporting documents and information to the Chief Financial Officer and/or upper management as requested.
  7. Responsible to work with multiple departments regarding sustainability.
  8. Responsible to serve as an active member of Resource Management Committee and is responsible to prepare the CHS financial report.
  9. Responsible to service as an active member of the Quality Assurance Focus Group.
  10. Provides expertise to staff regarding knowledge of Federal Regulations and ensures compliance in all facets.
  11. Responsible for ensuring staff is adequately trained and current with the necessary tools needed to complete their tasks appropriately.
  12. Responsible to cover or ensure surrogates are assigned when needed for EHR consults completion and ensures they are processed timely.
  13. Responsible for oversight and safeguard of State, Federal or private carrier’s user pass-codes for appropriate staff.
  14. Manages the Business Office within the established budget.
  15. Proposed and implements policies and procedures to meet Business Office goals and recommends updates as needed.
  16. Solves difficult problems associated with the Business Office. Analyzes problem accounts.
  17. Oversees preparation of internal financial reports including aging reports, uncollectible accounts, Catastrophic Health Emergency Fund (CHEF) cases, etc. Prepares external reports as necessary.
  18. Maintains knowledge of and complies with established Yellowhawk and other applicable policies and procedures and applicable Federal regulations. Monitors and ensures staff compliance of relevant procedures and regulations.
  19. Assists in care and upkeep of department equipment and supplies.
  20. Monitors customer relations with staff, patients, and the public.
  21. Maintains highest level of confidentiality.
  22. Performs additional duties as assigned.
 
Position Requirements

Minimum Qualifications

  1. Bachelor’s degree in Healthcare, Business, Management, or related field with 5 years’ of successful and demonstrated experience and management/supervision of medical billing, third party billing, Medicare and Medicaid practices/procedures/methods and staff; OR
  2. Medical Billing and/or Coding certification(s) with 7 years’ of successful and demonstrated experience and management/supervision of medical billing, third party billing, Medicare and Medicaid practices/procedures/methods and staff.
  3. Demonstrated knowledge of the billing cycle for multiple medical services and Third Party Revenue functions for receivable and payable. (e.g. Medical, Dental, Behavioral Health, Optometry, Audiology, Physical Therapy, etc.).
  4. Demonstrated knowledge of all Third Party billing provider-credentialing processes such as National Provider Identifier (NPI), Medicare Pecos (e.g., 855I & 855R applications, MODA, First Choice, Regence Blue Cross Blue Shield, etc.)
  5. Demonstrated knowledge of ICD-10, Healthcare Common Procedure Coding System (HCPCS), Coding Procedure Terminology (CPT) guidelines and modifiers.
  6. Demonstrated knowledge of Federal Regulations, Indian Health Care Improvement Act (IHCIA), and Centers for Medicare and Medicaid Services, guidelines for Federal Medical Assistance Percentage (FMAP).
  7. Demonstrated experience with computer software – e.g. Microsoft Office,
  8. Demonstrated experience with RPMS or other electronic healthcare system.
  9. Demonstrated ability to communicate effectively, both in writing and oral, in any situation, with peers, staff, management, local, state and federal agencies and the general public, on various topics including but not limited to policies, procedures, memoranda and training materials.
  10. Must possess a valid state driver’s license and meet and maintain Yellowhawk insurance requirements.
  11. Must submit to and pass a reference and criminal background check.
  12. Must submit to and pass a pre-employment drug and alcohol screening.

Preferred Qualifications

  1. Master’s Degree in Healthcare, Business, Management or related field.
  2. Professional Medical Coder and/or Billing License or Certification
  3. Experience in a Tribal Healthcare system.
  4. Experience and/or knowledge of history, culture and health needs of Native American communities preferred.
 
Closing Date Open Until Filled  
Supervised By Chief Financial Officer  
Salary $63,032.74 annual - $94,496.06 annual  
EOE Statement No employee or job applicant shall be discriminated against in the pursuit of employment due to Race, Color, Religion, Sex or National Origin or any other category protected by law, except as provided by the Indian Preference Act under Title 25, of the U.S.C.  

This position is currently accepting applications.

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