HEALTH REVENUE CYCLE MANAGER

Ketchikan Indian Community


Ketchikan Indian Community (KIC) Overview:

Ketchikan, Alaska is a cozy coastal town, rich in community and culture. Ketchikan Indian Corporation has the honor to be the governing body for the Natives in the Ketchikan area. The Tribe began direct delivery services to the native residents with only two staff Members in 1975. The staff has grown to over 100 employees with the increased identification of the Tribal community needs. Beginning in 1992 KIC became a signatory in a compact of self-governance between Southeast Tribes and the United States of America, providing services to Tribal Members in a Government to Government Relationship, upholding Sovereignty for Tribal Members. The Tribal Council, as the established governing body, provides oversight and works in collaboration with the KIC staff, who focus on daily business operations to provide the highest quality of programs and services to Tribal Members. Traditional Southeast Tribal values drive KIC. The KIC mission is to preserve Tribal Member’s sovereignty, enhancing economic and cultural resources and promote self-sufficiency and self-governance for their citizens through collaboration, service, and advocacy. KIC partners with the community and Tribal Members to deliver services and provide assistance in improving the lives of all Tribal Members.

INDIAN PREFERENCE:

Consistent with Public Law 93-638 and other federal laws recognizing inherent right of the Tribe to exercise Indian Preference. Documentation of Tribal Enrollment must be included with application submission.

Job Summary 

Support and participate with Leadership in facilitating processes, systems and procedures to insure compliance, and changes in Tribal healthcare environment that impact revenues.

The position is responsible for optimizing performance of the healthcare revenue cycle process – registration, HIM, charge capture, charge posting & remit, denials, and access, also responsible for direct supervision of respective staff.

KIC Competencies:

Cultural Competency: To be respectful and responsive to the health beliefs, practices, and cultural and linguistic needs of KIC Tribal Members. Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum.

Commitment: To serve Tribal Members and set a high standard for yourself in your performance; strive for results and success; convey a sense of urgency and bring issues to closure; and stay persistent despite obstacles and opposition. 

Customer Service: Meet/exceed the expectations and requirements of internal and external customers; identify, understand, and monitor the needs of both internal and external customers, always talk and act with customers in mind; and recognize working colleagues as customers.

Effective Communication: Ensure important information is passed to those who need to know; convey necessary information with respect, clearly and effectively orally or in writing

Responsiveness and Accountability: Demonstrate a high level of conscientiousness; hold oneself personally responsible for one's own work; and do the required fair share of work.

ESSENTIAL FUNCTIONS

  • Management of charge capture activities and process improvements between the front- end (scheduling, registration, customer service, insurance verification/alternative resource screening, time of service collections, charge capture, medical records) and back- end (billing, posting, accounts follow up, reporting, compliance, provider enrollment, denials) functions of the revenue cycle process.
  • Communicates performance measures and expectations to all employees involved in revenue cycle activity, provides them with ongoing feedback and support, and ensures they have proper training and tools (including policy changes) to perform their work duties effectively and efficiently.
  • Tracks, analyses, and reports healthcare revenue cycle performance targets (cash collections, aged AR, and denials), with special attention to billing outcomes.
  • Oversees and monitors compliance with healthcare billing and coding regulations.
  • Responsible for driving improvement initiatives in billing strategies, minimizing bad debt, improving cash flow, claims denials management, internal audits, and special projects as assigned by the Finance Director.
  • Lead revenue aspects of organizational business planning, month-end accounting close, annual budget revenue assumptions and, annual audit of financial statements.
  • Reviews and analyses the fee schedule for healthcare services; recommends and implements updates (at least annually) based on changes in the reimbursement environment, local market considerations, and other relevant factors.
  • Works with Finance Director to communicate, train, and support all key stakeholders in revenue cycle.
  • Coordinate EHR System administration for all billing, registration, and billing documentation.

Job duties above are intended to highlight essential functions, however incumbent might be asked to perform other related duties as assigned.

QUALIFICATIONS

  • Knowledge of
    • ICD-10;
    • Third party billing practices
    • Alaska Medicaid programs for Dental, Primary care and Behavioral Health
  • Proven Leadership experience and process management
  • Personable, friendly, confident, analytical and team player

PREFERRED QUALIFICATIONS

  • MBA, MHA, CPA or equivalent
  • Experience In Tribal Healthcare
  • Experience with Alaska Medicaid program
  • E.H.R. system administration role with ATHENA, RPMS, AK AIMS, Dentrx, Scrip Pro

Physical Activities Include: 

Ability to use hands to finger, handle, or operate objects tools, or controls; reach with hands and arms; climb or balance; stoop, kneel, crouch.  Each of the listed activities also requires standing, sitting, and walking,

Writing by hand and using a personal computer. Long hours in front of computer screen.  Frequently required to work extended hours.  Attending evening and lunch time meetings as requested by the Finance Director.  Traveling occasionally, using air and/or water transportation, to out-of-town meetings and functions.

Education and Experience: 

Bachelor’s degree in finance/accounting, healthcare management, business administration or related field plus 2 years revenue cycle management experience or have a minimum of an Associate’s Degree plus five 5 years of documented experience in revenue cycle management.

Any combination of related education and/or related experience will be considered if the candidate posses the demonstrated ability. 

This job description is not an employment agreement or contract.  Management has the exclusive right to alter this job description at any time without prior notice.

Ketchikan, AK

4 year(s) ago