Revenue Cycle Manager jobs in Washington

Hiring Preference: The Kalispel Tribe of Indians is an Equal opportunity employer. Consistent with federal law, the Kalispel Tribe of Indians applies Indian preference in employment. It is the policy of the Kalispel Tribe of Indians to give preference in hiring, promotions, and transfers into vacant positions to qualified applicants in the following order: 1) Kalispel Tribal Members; 2) Descendant or Spouse of an enrolled Kalispel Tribal Member; 3) enrolled members of other Indian Tribes; 4) all other applicants. At-Will Employment: Employment with the Kalispel Tribe of Indians is at-will and can be terminated with or without cause, and with or without notice, at any time, either at the option of the employee or the Kalispel Tribe of Indians. Drug Testing: The Kalispel Tribe of Indians is a drug free workplace. All applicants are subject to drug testing at the time of hire and at unannounced times during employment. Background Investigation: All candidates and employees may be subject to a background investigation. 

Summary of Functions

Revenue Cycle Manager (RCM) is responsible for oversight of the day-to-day operations of the revenue cycle functions of the Camas Center Clinic. This will involve supervising staff and ensuring the smooth flow of revenue cycles. The RCM will identify and resolve any issues that may arise and ensure the efficient and accurate management of our revenue cycle. Responsible for the coordination of all clinical insurance coding, billing, and credentialing for Camas Path Behavioral Health, Camas Center Medical and Dental Clinic performing the following duties:

Essential Duties and Responsibilities

• Planning, managing, and coordinating revenue cycle operations for medical, dental, and behavioral health departments.
• Managing and supporting clinic receptionists and patient registration staff.
• Monitoring billing, coding, and accounts receivable balances, and provider credentialing.
• Negotiates, implements, and manages contracts with insurance companies.
• Ensures patient/client complaints and billing issues are resolved, and initiates customer service improvements.
• Works with the IT and finance departments to manage practice management systems, ensuring the generation of essential patient and financial data in a confidential environment.
• Adhere to all applicable tribal, federal, or state privacy laws and regulations, including but not limited HIPPA, OSHA, and 42 CFR Part 2
• Develops strong inter-departmental relationships and works as a part of the team to meet the needs of the patients, clients, providers, staff members and the Tribe.
• Reviews ICD-10/CPT codes on all claims in preparation for processing electronic claims.
• Oversight and follow up with accounts receivable (AR) balances.
• Provide regular status updates to the Healthcare Administrator and CFO on billing and collection efforts of AR balances.
• Responsible for updating billing rates for services provided.
• Responsible for updating the sliding fee scale for services on an annual basis.
• This job description does not list all the duties of this position. You may be instructed by management to perform other duties as assigned
• Duties, responsibilities, requirements, and expectations pertaining to this job are subject to change as needed.

Supervisory Responsibilities

Directly supervises Clinic Receptionists and Patient Registration Specialist who verify patient’s insurance and demographic information either through the practice management system or other online resources. Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Education

• Any of the following certifications:  Certified Professional Biller, Certified Professional Coder, Certified Coding Specialist

Experience

• Minimum of 5 year’s related experience and/or training; or equivalent combination of education and experience required.
• Minimum of 5 years supervisory experience.
• Experience with ICD-10, CPT & DSM IV
• Requires a thorough understanding of medical billing, transaction processing, electronic claims transmission, charge and payment posting, claims denial resolution, governmental and private payer claims submission requirements, patient eligibility inquiry and financial reporting.
• Minimum of 5 years prior experience working with a clinical electronic practice management and electronic health record system is required.
• Must possess an understanding of all phases of the process of producing, transmitting, and recording the financial portion for all clinical charges, payments and adjustments including Medical, Dental and Behavioral Health.
• Knowledge of medical insurance plans, medical terminology and third part collection required.
• An understanding of grant reporting requirements desired.
• An understanding of tribal billing requirements desired.

Skills

• Must be computer literate with working knowledge of Microsoft programs and other computer software.
• Through knowledge of billing software and practice management software preferred
• Strong attention to detail, problem-solving abilities, and organizational skills are necessary to identify and resolve any issues that may arise in the revenue cycle process
• Ability to calculate figures and amounts such as discounts, interest, commissions proportions, and percentages.
• Ability to apply commons sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems involving several concrete variables in standardized situations.
• Ability to work within a team environment.
• Ability to maintain confidentiality

Physical Demands

• Requires the ability to lift and/or move objects weighing up to 25 pounds.
• Constantly requires the ability to give and receive detailed information through verbal communication.
• Constantly requires verbally expressing or exchanging ideas of important instructions accurately, loudly, or quickly.
• Constantly requires working with fingers rather than the whole hand or arm.
• Constantly requires repetitive movement of the wrists, hands and/or fingers.
• Occasionally requires standing and/or sitting for sustained periods of time.
• Occasionally requires raising objects from a lower to a higher position or moving objects horizontally.
• Occasionally requires stooping which entails the use of the lower extremities and back muscles.  Infrequently requires crouching.
• Specific vision abilities required by this job include close vision, distance vision, color vision, and the ability to adjust focus.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the worker is frequently subject to inside environmental conditions, which provide protection from weather conditions, but not necessarily from temperature changes.  The noise level in the work environment is usually moderate.

Disclaimer: Certain Licenses and Certification requirements can be obtained once hired.