Indiana Health Centers, Inc.Job Expectations

Title

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Business Systems Manager

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Exempt

Reports to

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Chief Financial Officer (CFO)

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Date last revised: 12/10

Supervises /

Billers, Pay Post Clerk

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Salary Grade: 11

Summary

/ The employee, under the general direction of the CFO, is responsible for the maintenance of all Accounts Receivable and Billing related record keeping systems and involves a technical independence guided by administrative routines, requirements of others and established schedule. The position provides guidance of a functional nature to staff members directly involved with the financial component, both in the corporate office and at the sites. Position supervises the Billing Department Personnel. Working with the Data Base Administrator and the IT vendor, the employee participates as a member of a team who develops and implements, maintains, and evaluatescorporate information systems.
Evaluation of performance /

Performance will be evaluated based on meeting specific goals, productivity measures, employee satisfaction scores, and other quality indicators for this position such as: IHC strategic objectives; site strategic objectives; functional capabilities; leadership and/or employee capabilities; IHC commitments, quality measures, and productivity measures.

Application of knowledge / Requires expert knowledgeof an extensive body of medical billing and medical coding rules and regulations, specifically related to state Medicaid reimbursement – Healthy Indiana Program (HIP) and Medicaid Contract Offices (MCO’s). Requires knowledge of, precedents, procedures, and past practices applicable to medical billing and medical coding and cost recovery along with knowledge of IHC’s structure, goals, and specialized terminology.Requires knowledge of CPT and ICD 9 coding. Knowledge permits the employee to develop new approaches or improve current administrative operations within the confines of the laws and regulations.
Medical Coding and Cost Recovery:
  • Completion of all 2nd and 3rd party requests for payments forms
  • Preparation of all data input forms for the accounts receivable
  • Manages accounts receivables and past due accounts
  • Conducts AR monthly, quarterly, and annual AR “scrub”
  • Manages provider credentialing, privileging, and MCO panel award
Information Management and Data Analysis:
  • Compiles information for periodic financial reports
  • Assists the CFO on special projects as needed.
  • Analyzes and presents data in a format conducive to decision-making by the Management Team and Supervisors
  • Identifies and develops measuring tools for corporate strategic objectives
  • Assists with the identification of data trends.
  • Assists management with the use of information sources
Supervision and Coordination with CFO
  • Supervises Accounts Receivables and Payment Posting Clerk—reviews work and evaluates performance.
  • Ensures knowledge advancement and professional development of billing personnel
  • Assist CFO in establishment and oversight of internal controls for AR/billing
  • Prepares required reports as directed by the CFO

Job controls and complexity / Receives overall goals, objectives, priorities, and deadlines; interpretscurrent guidelines and creates or revises current policies, processes, and procedures for new methods if required. Processes and procedures vary from one assignment to the next, although assignments are related in function and objective. Based on assignment, the Business Systems Manager must use diverse but conventional methods, techniques, or approaches. Work has a controlling impact in day-to-day operation of medical coding and cost recovery services. Work affects the IHC’s business, cash flow, and revenue in a substantial and demonstrable way.
Nature and purpose of contacts / Contacts are primarily routine and structured, typically involving department staff and supervisors as well as employees of other departments, MCO representatives, IHC providers, and consumers. Contacts are to coordinate and advise work projects and to collaborate and solve recurring problems.
Critical skills and behaviors / Leadership–Able to: share compelling vision and direction; build strong, engaged, and empowered teams; drive and foster IHC mission, vision, and values; drive productivity and achieves result; follow standard problem solving process; make data-driven, evidenced-based decisions; hold others accountable for performance.
Strategic Planning – Able to:
  • Demonstrate near and midrange planning skills
  • Anticipate and alert others to problems with projects or processes
  • Evaluate and monitor corporate strategic objectives
  • Develop department strategic goals, objectives, and action plans aligned with IHC’s
Logic and analysis – Able to:
  • Demonstrate analytical problem solving, decision-making, and trend analysis skills
  • Draw evidenced-based conclusions; recommend and implement evidenced-based solutions
  • Perform necessary mathematical calculations
  • Organize a variety of statistical figures
Communication– Able to:
  • Demonstrate effective verbal and written communication with a multidisciplinary team
  • Maintain effective working relationships with management team and other staff
  • Read, understand, organize, and effectively explain complex, financial and statistical data
Medical Billing and Accounts Receivable – Able to:
  • Demonstrate knowledge of accounting principles and methods
  • Demonstrate knowledge of ICD-9 and CPT coding
  • Apply recent regulations/guidelines on non-profit, health care billing and revenue
  • Understand, interpret, and prepare financial reports
Administration and Management –Able to:
  • Prepare detailed, organized, and accurate work product; consistently meet deadlines.
  • Manage the medical billing/accounts receivable department
  • Demonstrate effective supervisory skills: recruiting, mentoring, disciplining, and developing
  • Develop high performing teams; maintain a team approach to problem solving work flow
  • Prioritizetasks and time; follow up with subordinates, superiors, and co-workers
  • Make decisions and judgments that are demanding and interpretive; tolerates ambiguity
  • Plan and organize work with minimal supervision

Process Improvement – Able to:

Develop and document standard work and manage work processes to time and standard

Analyze work flow and implement process improvements where necessary

Design, initiate, and/or participate in process improvement projects

Technology –proficient in computer skills, including typing and use of Microsoft Word, Excel, Outlook, Access, and eCW, etc.
Experience, education, degrees, licenses / BA/BS degree from an accredited school with 3-5 years experience in medical billing and 3 years experience supervising non-exempt staff. Experience may be substituted for education. Experience with MCO’s, FQHCs, and/or electronic medical records preferred.
Physical demands and work environment / Work is considered non-strenuous and is primarily sedentary with some walking, standing and carrying of light objects. Must be able to operate general office equipment, including computers, telephone, etc.The work environment is low risk with adequate lighting, ventilation and heat where normal precautions must be observed. Some travel is required to visit clinic sites.