Revenue Integrity Supervisor

Revenue Integrity Supervisor

Department: Revenue Cycle

Program: Health Systems

Reports To: Revenue Cycle Manager

Supervises: Charge Capture Specialist, Revenue Cycle Technicians, Biller/Coders, Insurance Processing and Denials Specialist

Employment Status: Full-Time

FLSA Status: Exempt

Schedule: 40 Hours/52 Weeks

Preference: TERO Ordinance 2017-01, P.L. 93-638

Job Summary

Revenue Cycle Integrity Supervisor is responsible for the day-to-day performance of the revenue cycle process. The Supervisor is responsible for guiding and coordinating the work for the group of employees towards established goals and objectives. The Revenue Integrity Supervisor has an in depth understanding of the processes of their team and can actively troubleshoot issues The Supervisor serves as a subject matter expert for new employees and can serve as subject matter experts to other groups at the direction of the Manager.

Essential Functions

• Supervising, training, and evaluating revenue cycle staff, ensuring they meet performance standards and department goals
• Identifying areas for improvement in billing, and collections processes
• Monitoring and managing claims process, including submission, follow-up and denial management in order to optimize the revenue cycle process
• Investigating and resolving claim denials, collaborating with insurance carriers and other departments to reduce denials and expedite reimbursement
• Oversees and verifies provider enrollment with Medicare, Medicaid, and contracted insurances
• Maintains clear communication with staff, management, and other departments to address issues, share information, and streamline processes
• Ability to analyze data and identify trends to improve revenue cycle
• Knowledge of healthcare regulations and compliance requirements
• 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

• Sedentary work – Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.

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 Categories

• 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

Equipment used for job: Computer, phone, scanner, copier, electronic health records

Travel

• Local
• In-State

Qualifications

Education

• Associates degree in Finance, Accounting, Business Management, Health Care Administration or related field or a combination of education and experience in a related field may be substituted for a degree

Experience

• Three (3) years of revenue cycle experience
• One (1) year of experience or demonstrated proficiency as a supervisor

Preferred

• Knowledge and experience working with cultural diversities

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 multi-task, work independently, and meet deadlines
• Strong understanding of revenue cycle management and regulatory agencies
• Experience in Federal and State regulatory associated to billing and coding
• Electronic Health Record (EHR) experience

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.