Location: Nevada, Rural Douglas and Mineral County
Responsible for the overall financial viability of the program ensuring the center is appropriately reimbursed for all services provided within regulatory and contractual guidelines. This includes planning budgets, revenue data, forecasting market share, regulatory impacts, claims management, identifying strategies to increase customer base and revenues, and identifying sustainability plans. Services are provided in an integrated behavioral health setting, of multi-disciplinary para-professional and professionals with a person-centered, family-centered, recovery-oriented approach to care.
- 5-7 years in Professional Billing and Revenue Cycle
- Bachelors Degree
- Experience in healthcare industry
- Must have excellent verbal, written and interpersonal communication skills.
- Proficient in MS Word/Excel. Ability to research material via the internet.
JOB RESPONSIBILITIES AND COMPETENCIES
- Direct responsibility to plan, organize and implement process and business improvements on designated strategic initiatives;
- Ensure that appropriate internal control safeguards are maintained for provider credentialing, professional coding, health system billing, cash collections, accounts receivable records and self-pay process;
- Develop, implement and present business operations and financial planning policies and procedures throughout revenue cycle;
- Monitor and maximizes reimbursement through denial prevention and accounts receivable management;
- Develop and implement, along with HR Business Partner, departmental procedures, standards, tools and techniques to effectively process claims and maximize collections; and
- Coordinate with Information Resources in the development, evaluation and maintenance of information systems for electronic billings, electronic remittances, payer reimbursement, payer confirmation of claims, denial management, corporate compliance and collections to maximize reimbursement, provide peak performance and reporting.
- Person-centered, family-centered, recovery-oriented care;
- The ability to recognize your own limitations and respond to difficult situations;
- The ability to apply your knowledge and research to clinical problems;
- The capacity to be critical and analytical;
- To work in a self-motivated and independent way;
- Excellent communication and interpersonal skills in order to deal with people in distress;
- The ability to collaborate with colleagues and community partners from other disciplines;
- The ability to adhere to all privacy and confidentiality policies; and
- The ability to use electronic health records.
Employee will be expected to participate in continuous learning, competency building and maintenance of competency skills.
TYPICAL WORKING CONDITIONS
Work is performed in structured environments.
Reports to and is supervised directly by the Program Supervisor. Employee is also accountable for understanding and complying with CPLC policies and procedures.