Business Office Manager - Millinocket, United States - Wabanaki Public Health and Wellness

Description

Job Description

Wabanaki Public Health & Wellness (WPHW) is growing, and we are excited to be adding new people to our team If you value inclusivity, balance, and cultural centeredness and have a true passion for serving others, you may be a great fit for our team WPHW is a non-profit organization that serves four federally recognized tribes located in five communities: the Houlton Band of Maliseet Indians, the Aroostook Band of Mi'kmaq, the Passamaquoddy Tribe at Indian Township, the Passamaquoddy Tribe at Pleasant Point, and the Penobscot Nation. Wabanaki traditions, language, and culture guide our approach and describe the ways we live in harmony with each other and the land we collectively share. Services are available to community members living on and off-reservation across the state of Maine.

Position Summary:

Currently, the Center for Healing and Recovery has two direct care facilities located in Bangor, ME and Millinocket, ME. Offering Intensive Outpatient Program (IOP), Detox, Medication Assisted Treatment, Case Management and Counseling. This position requires a strong understanding of medical terminology, coding guidelines, licensing, credentialing, medical records, and insurance regulations in the context of substance use and mental health treatment. Familiarity or experience working with Kipu EMR and Collaborate MD is a plus. If you are a compassionate, dedicated and skilled Business Office Manager looking to contribute to a dynamic and expanding healthcare team in the field of substance use and mental health treatment, we encourage you to apply.

Duties and Responsibilities:

• Responsible for direct supervision of revenue cycle team to include recruiting, orientation, performance evaluations and training for Business Office associates. Resolves concerns and grievances and seeks HR or Director guidance on unresolved issues.
• Establishes standards to ensure all processes and procedures are followed correctly.
• Coordinates and facilitate communication between business and medical office teams.
• Conducts regular departmental meetings, ensuring minutes are recorded and disseminated.
• Provides in-service training and continued education for all CHR staff as required.
• Responsible for the revision and/or development of business office policies and standard operating procedures.
• Collaborates with the CHR team on short-term and long- term planning to increase access to care, programming, and staffing.
• Participates in all staff meetings, educational opportunities, quality meetings and accomplishes quality improvement initiatives, and any of committee as assigned by the Director.
• Ensure compliance with any grants or funding requirements.
• Completes weekly, monthly and quarterly reports and submits for authorized signature as required.
• Adheres to all WPHW policies and protocols. Reports all incidents, regardless of severity, immediately and completes an incident report and investigation form.
• Travel to assigned locations to assist with other sites with the collection process when support is necessary.
• Serves as the Credentialing Specialist, maintains appropriate documents and licenses required to assure compliance with regulatory mandates.
• Apply for and maintain State licenses, and any other licenses or certifications as needed to meet state and facility requirements.
• Maintains files with current state licenses, DEA certificates, malpractice coverage, professional liability and continuing education units, and any other required credentialing documents for all providers.
• Serve as primary user for MaineCare/Health PAS-online, communicating efforts with Director(s).
• Update and maintain all external credentialing systems including CAQH, PECOS, Availity, and other required payer platforms.
• Complete enrollment and ensure Medicare, Medicaid, and other payer revalidations/recredentialing applications are completed and updated timely without lapse in enrollment.
• Respond to inquiries from internal and external customers on credentialing and privileging issues as they arise.
• Enter, update, and maintain all internal credentialing databases; prepare and provide information to internal and external customers as appropriate.
• Manager of electronic health records (EHR) system and tracks task tickets with EHR vendor.
• Ensures the proper access, preparation, documentation, storage, copying and dissemination of medical records in accordance with HIPAA and privacy laws.
• Instruct training program for new and established team members and support the on boarding of new providers/offices.
• Responsible for templates and forms inside electronic health record, complying with all governing requirements, working with various healthcare professionals.
• Manages workflow, troubleshooting, and compliance issues with EHR Client Portal and Provider Portal.
• Responsible for reporting compliance with Electronic Health Records system to Program Director(s).
• Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately.
• Review, evaluate, and test new software and software upgrades.
• Identify, troubleshoot, resolve workflow questions within the offices through taking helpdesk calls and rounding within offices.
• Prepares data reports from EMR for grant/funding reporting requirements.
• Oversees and/or performs revenue cycle tasks and helps establish, revise, and implement practice policy and operating procedures.
• Assures maximum reimbursement for medical and behavioral health services rendered by health professionals.
• Ensures that admission verifications and authorization procedures are carried out timely and accurately.
• Reviews census and performs daily audits to ensure accuracy and address discrepancies with appropriate staff.
• Reviews fees and makes recommendations for change.
• Assures that the facility adheres to all compliance mandates, obtains proper signatures on forms, notifications to patients and enforces ethical billing practices.
• Assist team with billing research, coding requirements, field billing, and addressing insurance carrier questions.
• Demonstrates and maintains the standards and requirements of the Health Insurance Portability and Accountability Act, (HIPAA); and 42 CFR Part 2; while ensuring the protection and security of personal, confidential, and identifiable information in a professional and responsible manner and executes all measures to prevent from unauthorized disclosures.
• Understands and complies with mandated reporting requirements- children and elder abuse, neglect, or exploitation.
• Supports community-based meetings and events as directed.
• Completes other miscellaneous administrative and other duties as needed.

Education and Experience Required:

• Requires high school diploma or GED with post high school courses in accounting, finance, billing, coding, and/or business administration. Associates degree preferred.
• Requires a minimum of three years of experience in a medical or behavioral health facility related billing environment to include scheduling, admissions, verification of benefits, and pre-certification.
• Understanding of how insurance processes work including the verification, completion of third-party liability requirements, secondary payer forms and authorizations.
• Minimum of two years of supervisory and management experience required.
• Experience working with Health PAS, Kepro and HealthInfoNet.
• Experience working in Tribal Communities preferred.

Must pass all agency and program required background checks.

Skills and Qualifications Required:

• Demonstrated ability to exercise initiative, independent judgment and be a self-starter who works with integrity while also being a strong team player and embrace a culturally diverse setting.
• Ability to communicate ideas, instructions, and other information in a clear and precise manner using both written and oral forms of communication.
• Proficiency with computers and MS Office and Teams, experience with medical billing software; Kipu and Collaborate MD experience a plus.
• Ability to remain calm in tense situations, using sound judgment and remain impartial when making decisions affecting operational and staffing decisions.
• Must be flexible with excellent attention to detail and an ability to manage multiple tasks.
• Willingness and ability to travel with valid State of Maine Driver's License, insurable under the agency's automobile insurance plan.

Wabanaki Public Health & Wellness is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.