Job Description
Job Description
Central Business Office Supervisor
Department: Revenue Cycle
Reports to: Revenue Cycle Manager
Employment Status: Full-Time
FLSA: Exempt
Schedule: 40 Hours/52 Weeks
Preference: TERO Ordinance 2017-01, P.L. 93-638
Job Summary
The Central Business Office Supervisor oversees daily operations in health system billing, managing biller/coders, insurance processing and denial claims specialists. The Central Business Office Supervisor will review claims, collaborate with departments to ensure necessary claim adjustments, and work with registration to ensure accurate chart collections for each patient. The Central Business Office Supervisor is also responsible for quarterly reviews on billing and compliance with health system providers..
Essential Functions
- Manage the daily operations of the central billing office, ensuring accurate and efficient processing of billing, coding, and insurance claims
- Supervise Biller/Coder, Insurance Processing, and Denials Specialist
- Provide training, set performance goals, conduct regular performance review and resolve any work-related issues
- Conduct comprehensive claims reviews to ensure accuracy and compliance
- Work with department heads to identify and implement necessary adjustments to claims processes
- Partner with registration and other departments to ensure accurate and streamlined billing workflows
- Oversee denied claims processing, develop strategies to reduce future denials, and work to optimize revenue cycle performance
- Monitor billing practices for compliance with regulatory stands and perform quarterly audits to maintain high standards
- Continuously evaluate and enhance billing processes to increase efficiency, reduce errors, and improve financial outcomes
- Responsible for providing Health Systems provider training for all new hires and ensure billing and coding compliance
- Ensures compliance with Tribal, federal, state, and local employment laws and regulations, Tribal policies and TERO ordinance
It is the intent of this job description to highlight the essential functions of the position; however, it is not an all-inclusive list. The incumbent may be called upon and required to follow or perform other duties and tasks requested by his/her supervisor, consistent with the purpose of the position, department and/or the Kenaitze Indian Tribe's objectives.
Working Conditions
Lifting Requirements
- Light work – Exerting up to 20 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg control requires exertion of forces greater than that of sedentary work and if the worker sits most of the time, the job is considered light work.
Physical Requirements
- Stand or Sit (Stationary position)
- Walk (Move, Traverse)
- Use hands/fingers to handle or feel (Operate, Activate, Use, Prepare, Inspect, Place, Detect, Position)
- Talk/hear (Communicate, Detect, Converse with, Discern, Convey, Express oneself, Exchange information)
- See (Detect, Determine, Perceive, Identify, Recognize, Judge, Observe, Inspect, Estimate, Assess)
- Repetitive Motion
OSHA
- Category III - Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid
Equipment and Tools
List Equipment used for job: Computer, phone, electronic health records
List Tools:
Drives KIT or Personal Vehicle: Personal
Travel
- Local
- In State
- Out-of-State
Qualifications
Education
- Associate's Degree in related field or a combination of education and experience in a related field may be substituted for a degree
Experience
- Five years (5) of health systems billing experience to include: billing, coding, denials management, insurance payment collections, and reporting
- Two (2) years of supervisory experience
Preferred
- Knowledge and experience working with cultural diversities
- Knowledge of Indian Health Services facility operations
- Knowledge of Purchase Referred Care and other third party insurances including Veterans Administration (VA)
License/Certification
- At least one of the following certifications: Certified Professional Coder + Certified Professional Biller (CPC + CPB) or Billing Coding Specialist Certification (BCSC)
- Must have a valid Alaska State driver's license and must remain insurable under the Tribe's policy
Special Skills
- Proficiency with Microsoft Suite, or obtain training within 90 days of hire
- Conducts business in a service-oriented manner that is attentive, pleasant, respectful and kind when dealing with un'ina, visitors, co-workers and others
- Ability to work independently as well as collaboratively
- Ability to multi-task, work independently, and meet deadlines
- Knowledge of the following healthcare services: Primary Care, Dental, Optometry, Laboratory, Therapy Services, Radiology, Pharmacy, Behavioral Health, etc.
- Strong leadership and mentorship skills Excellent verbal and written communication skills for collaboration with team members, other departments, and external stakeholders
- In-depth knowledge of health care billing practices, coding standards (such as ICD-10, CPT, and insurance claim processing
- Familiarity with federal and state healthcare billing regulations and compliance requirements, including HIPAA and insurance guidelines
- Skilled in analyzing billing data, identifying trends, resolving claim denials, and implementing effective strategies to improve revenue cycle performance
- Knowledge of basic medical terminology and clinic systems
This position is a Covered Position subject to all requirements of the Alaska Barrier Crimes Act (ABCA) and to the Indian Child Protection and Family Violence Prevention Act, (ICPA). ABCA and ICPA requirements apply and must be complied with at all times in order to remain in the position.
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