Campus Pride Jobs

Business Office Manager

Job Closing: May 15, 2024

Job Code: 11-9199 Salary: $33,820.80 - $98,113.60

Status: Full-time, Exempt, Permanent Location: Health Services

Department: Business Office Reports To: Health Director

SUMMARY: Incumbent is responsible for managing the day-to-day operations of the SRMT Health Services Business Office by providing supervision, advice, training and enforcing established policies. Supervises the business office supervisors and indirect staff, in accordance with office policy, position descriptions and applicable laws.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

· Supervise and coordinate the functions and staff of the Business Office, which include: Branches in Collections, Cash Control; Billing, Patient Registration and Benefits; and Health Information.

· Responsible for providing technical assistance to management, medical providers, patients, and other facility personnel regarding the work of the departments.

· Responsible for the creation, implementation and maintenance of the Business Office policies and procedures, which comply to the practices of the Saint Regis Mohawk Health Services Ambulatory Care Facility.

· Policies and procedures will cover the registration/admission processes, to include insurance verification and pre-certification, billing and collection processes, cash control procedures for the posting of payments and contractual, and the submission of periodic reports and their deadlines as required by the Health Care Financing Administration and other agencies.

· Responsible for coordinating and distributing workloads.

· Review the workload and progress of the office.

· Display initiative in promoting suggestions to improve the overall operations as well as stressing cost containment.

· Serves as the focal point for all evaluations of the Business Office.

· Determines the impact of such evaluations on operating programs and directs corrective action compliance through evaluation analysis in a timely and efficient manner.

· Develop and implement a comprehensive internal quality control system within the program.

· Determines the effectiveness of such controls and their impact on the program.

· Establishes and maintains a working relationship with Medicare and Medicaid intermediaries, state and federal agencies, area employers and private insurance companies.

· Develop statistical reports and control methods in determining receivable and collections.

· Is responsible for the completion and submission of budgetary documents and reports required.

· Responsible for acquisition and maintenance of hardware and software for electronic claims processing, and the require equipment and supplies for an efficient business office operation.

· Works with supervisors to monitor productivity of all reporting areas to ensure it meets production standards. Assures staff is provided a work environment conducive to productivity and good health.

· Ensures compliance with Tribal, Federal, state and other regulatory laws which include provider contracts, PRC and support agreements.

· Due to the large expenditures under the incumbent’s control, s/he must have a good working knowledge of revenue reconciliation processes to prepare budgetary/revenue documents for the health director.

· Coordinate Business Office policies and procedures, patient registration and admissions eligibility, resource patient management systems and alternate resource programs through subordinate supervisors.

· Through subordinate supervisor, coordinate collections for the third-party reimbursement program.

· Utilize the patient data base information system which includes conducting patient interviews to update information on demographic and third-party resources data.

· Present final determinations on direct care eligibility of all individuals seeking care who have not previously established eligibility and of those individuals who have been treated previously and eligibility is now in question.

· Determine whether patient care falls within the scope of the Indian Health Service program.

· Completion of all credentialing of providers and insurances.

· Participate on various committees, i.e. Health Plan, Quality Assurance etc.

SUPERVISORY RESPONSIBILITIES: Serve as Supervisor of the Business Office staff. Responsibilities include coordinating and distributing the workload. Reviewing the daily workload and progress of the office. Display initiative in promoting suggestions to improve the overall operations. Knowledge of the purchased referred care program, third party insurance billing (including Medicare, Medicaid, and Commercial insurance), and coordination of benefits rules and their application, and Medicare-Like-Rates (MLR).

QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Due to the sensitive nature of information and personnel files maintained within the Business Office, must maintain strict confidentiality at all times.

EDUCATION and/or EXPERIENCE:

• Associates Degree in Business, Health Administration, or Finance and (5) five years relevant experience and (3) three years relevant supervisory experience OR

• (8) eight years of relevant experience in health insurance claims or medical billings and three (3) years related supervisory experience OR

• Bachelors or Master’s Degree, in Business or Health Administration or Public Administration with three (3) years’ relevant experience and three (3) years supervisory experience is preferred.

PERFORMANCE EXPECTATIONS: Uphold all principles of confidentiality and patient care to the fullest extent. Adhere to all professional and ethical behavior standards of the healthcare industry. Interact in an honest, trustworthy and dependable manner with patients, employees and vendors.

OTHER SKILLS and ABILITIES: Strong oral and written communication skills required. Must have excellent computer skills, including word and excel. Knowledge of HIPPA, state and federal guidelines on privacy, transactions and extensive familiarity with healthcare relevant legislation and standards for health information and patient privacy.

REASONING ABILITY: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

The Saint Regis Mohawk Tribe strives to be an equal opportunity employer dedicated to the policy of nondiscrimination based on race, sex, marital status, sexual orientation, religion, national origin, age, physical disability, veteran status or any other non-job-related factor.

The successful candidate must complete a PPD test.

The successful candidate must pass a test for illegal substances prior to employment being confirmed.

The successful candidate must pass a criminal background check prior to employment.

Applicants must submit letter of interest, resume, and supporting documents (certificates, degrees, licenses). Applicants that are eligible for native preference must include Tribal Identification Card, Status Card or letter to be eligible for Native Preference. All submissions can be emailed to human.resources@srmt-nsn.gov or by mail to Human Resources, Saint Regis Mohawk Tribe, 71 Margaret Terrance Memorial Way, Akwesasne, NY 13655. Due to our network security, we are unable to open hyperlinks. Applicants will need to attach their documents as a PDF or WORD files if emailing. Applicants must clearly outline that they meet the qualification requirements on their resume.

NATIVE PREFERENCE POLICY

The Saint Regis Mohawk Tribe strives to be an equal opportunity employer dedicated to the policy of nondiscrimination based on race, sex, marital status, sexual orientation, religion, national origin, age, physical disability, veteran status or any other non-job-related factor. Among qualified applicants, the SRMT will give preference to the qualified native applicant.

DRUG TESTING POLICY

All positions require the successful candidate to pass a drug test for illegal substances prior to employment being confirmed.

BACKGROUND CHECK

Some positions require candidate(s) to successfully pass a criminal background check prior to beginning employment, used solely for employment related purposes. Depending on the position there maybe multiple background checks.

ELIGIBILITY LIST

A list of qualified candidates is created from interviews that may be used for Emergency Hire individuals to similar positions within the Saint Regis Mohawk Tribe for a period of six months.

INTERVIEW

Testing in the applicable skills may be required as part of the interview process.

EMPLOYEE COVID VACCINATION POLICY

Effective July 3, 2023, the Saint Regis Mohawk Tribe no longer requires the COVID-19 Vaccination for any positions within the organization, to include Health Services.