Healthcare Billing and Reimbursement Manager
Description
PURPOSE
Strengthening Resiliency and Supporting Recovery
VISION
Promote and enhance access to intellectual, developmental, and behavioral health services that improve the lives of those in our community.
VALUE
We pledge to deliver quality services through partnerships with individuals, families, and community stakeholders. Texoma Community Center strives to develop and equip all staff with Trauma-Informed Care knowledge and competency-based skills. Trauma-Informed Care means treating the person as a whole, taking into account past trauma and the resulting coping mechanisms when attempting to understand behaviors.
Our goal is to provide effective treatment as well as improving the quality and impact of care.
Join a team of dedicated service providers who seek to promote the accessibility of services that improve quality of life and support self-determination for persons with mental and developmental disorders. Texoma Community Center (TCC) is one of 39 Texas Community Centers, which are governmental entities as defined by Title 7 of the Texas Health and Safety Code.
Position Summary:
Directs and supervises the activities of the claims and provider reimbursement personnel. Sets procedures for filing reimbursement claims and ensures timely and accurate claims payments. Monitors, evaluates, and reviews all reports in support of reimbursement claims. Develops policies and procedures compliant with fiscal and regulatory requirements as well as accepted accounting principles. Responsible for updates to billing software with rates, codes, and procedures. Position serves as main point of contact with Managed Care Organizations (MCOs), Medicaid, Medicare, and Commercial Insurance plans to include contracting, rate negotiation, dispute resolution, and staff roster submissions. Responsible for policies and procedures related to client financial assessments, collection of fees (maximum monthly fee, copays, deductibles) and provides oversight to Center staff regarding training/completion of client financials, customer service, and collections. Assists in the development and reconciliation of cost reports and other required state reporting. May assist supervisor and/or other Center staff with special projects or assignments. Operates under trauma-informed and recovery-oriented models of care which align with CCBHC standards. |
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Qualifications:
Education and/or Experience:
- Bachelor’s Degree with major course work in Business, preferred. Experience and education may be substituted.
- Four (4) years of Supervisory responsibilities.
- Excellent communication and organizational skills with the ability to interact in a professional manner with a variety of staff, clients, and other community and State agencies
- Extensive knowledge and skill in Microsoft Office, Word, Access, Outlook, etc. is required.
- Experience working with individuals with mental illness and/ or addiction issues desirable.
Certificates, Licensure, Registrations:
- Current driver’s license and vehicle for use while at work required
Knowledge, Skills and Abilities:
- Ability to speak a second language relevant to population served preferred
- Must be self-motivated, organized and detail oriented
- Knowledge of Microsoft Office Suite
- Consistently practices Trauma-informed Model of Care, understands and considers the pervasive nature of trauma.
- The knowledge of cultural differences and ability to work with individuals from different cultural backgrounds.
General Requirements:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The requirements listed below are representative of the general knowledge, skill, and/or ability required:
- Ability to add, subtract, multiply, and divide
- Ability to handle money/make change
- Ability to generate, read, interpret, and take action as it relates to basic financial statements, national and state regulations, operational and maintenance and organizational policy / procedures
- Ability to effectively communicate
- Ability to work cooperatively and communicate effectively to maintain good working relationships
- Ability to work with skill in identifying problems
Security/Access:
- Will have access to confidential information abiding by the organization’s privacy policies and regulations concerning this information
Equipment, Tools, Materials:
- Standard office equipment
- First Aid/Spill Kits
Benefits
The benefits offered to TCC employees are competitive, comprehensive, and demonstrate the company’s commitment to the well-being of its employees.
Benefits include:
- Medical, Dental, and Vision insurance offered
- Employer paid Life Insurance & Short-Term Disability
- Additional Opt-in benefits
- Wellness Credit
- Designated Paid Holidays
- Paid Time Off (PTO)
- Extended Illness Leave
- Retirement Plan
- Payroll Direct Deposit
- Flexible Spending Account (FSA)
- Designated Paid Holidays
- Supports Federal Student Loan Forgiveness Program