104206

JOB TITLE    Manager III
WAGE    $53,239-$60,238 DOE Annually
JOB STATUS    Full-time
SHIFT    8am – 5pm, Monday – Friday (Variable)
POSTING NUMBER    104206
HIRING PROGRAM    Reimbursement
JOB LOCATION    Lytle Admin
BENEFITS    Full
POSTING DATE    01/06/23
CLOSING DATE    01/20/23

Agency vehicles may be available; however, mileage is reimbursed for some activities requiring use of personal vehicles.  The selected applicant must be able to attend approximately 3 working days of staff development orientation in Lytle, TX.

GENERAL DESCRIPTION OF DUTIES AND RESPONSIBILITIES:

The Director of Reimbursement is responsible for managing the day-to-day activities of the billing department; client data system, billing of Medicaid, Medicare and 3rd party payers, collections, and disputing claim denials, etc.  The Reimbursement Director (designee) processes the reporting of client data to state agencies as required through the performance contract with HHSC/BHS/IDD and provides oversight to billing activities with the ECI Program.  Position has working knowledge of Code of Procedural Terminology (CPT) codes, ICD10 codes and works closely with internal program managers to develop appropriate service codes that capture and support not only the delivery of services in Mental Health, Intellectual Disabilities, and ECI programs but insuring the billing of services.  Requires close collaboration with Information Services regarding the maintenance of the client data system.  Requires an intimate knowledge of the Electronic Health Record and how the interface impacts the end user.  Works closely with end users and collaborates with the support team to resolve software related issues that arise.  Provides oversight to the Tejas contract and is primary contact for generating tasks and monitoring completion.  The position ensures compliance with established laws, regulations, practices, and procedures.  Position requires good judgement, initiative and the ability to work independently to complete assignments that are complex in nature.  Must be familiar with TMHP or have the ability to learn TMHP for billing purposes.  The Director is skillful in organizing, supervising, and directing the work of others to maximize revenues and efficient reporting of client data.  The Director works with the accounting team, demonstrates the ability to develop policies and procedures that guide the functions of the Reimbursement Department and the staff performing duties related to reimbursement and financial assessments.  Excellent communication and interpersonal skills with a customer-service focus are required.  The position reports to the Chief Financial Officer and may require travel within the local service area and statewide as necessary.  This is a high stress environment and requires an individual that can work under stressful conditions.

MINIMUM JOB QUALIFICATIONS:

Bachelor’s Degree in business, finance or health administration or related field plus three (3) years of work experience in the health care/medical field with direct responsibility for billing, claims management, interfacing with managed care organizations, medical coding, electronic medical records or similar activity.

OR

High School Diploma or General Education Diploma and 10 years documented experience in billing, direct data management for a medical office/clinic for an agency with 200+ direct service providers.  Electronic Medical Record management; TMHP interaction.
Superior customer service skills are essential.
Working knowledge of Managed Care, Commercial Insurance, Medicare, and Medicaid reimbursement.
Must have advanced computer skills, be proficient with Excel and database programs and possess strong analytical skills.


PREFERRED JOB QUALIFICATIONS:

Certification in revenue enhancement by nationally recognized organization.
Five (5) years’ experience in the Texas Community Center System managing revenues and client data.
Three (3) years of supervisory experience.
Experience in a community healthcare environment with emphasis on maximizing revenues through accurate and aggressive billing and collections.
Three (3) years’ experience with HHSC BHS/IDD/ECI/SUD, Medicaid, Medicare, Managed Care, and Medicaid Administrative Claiming.
Five (5) years’ experience with Electronic Health Record Billing platform.


KNOWLEDGE, SKILLS, AND ABILITIES:

Knowledge of rules, regulations and standards that govern reimbursement services associated with DADS, DSHS and ECI contracts.
Knowledge of DADS and DSHS performance contracts.
Knowledge and experience with billing Medicare, Medicaid, and 3rd party resources.
Knowledge and experience with Medicaid Administrative Claiming policies and procedures.
Knowledge and experience with healthcare related billing and collection procedures.
Ability to supervise and manage workforce resources to maximize efficiency.
Ability to work under conditions requiring physical stamina and ability to work in a stressful environment timeline.
Must possess excellent computer skills.



OTHER SPECIAL INFORMATION:

Apply in person at:  19965 FM3175 North, Lytle, Texas or submit application and resume to:
Camino Real Community Services
ATTN: HRS
P.O. BOX 725, Lytle, TX.  78052
FAX: 830-772-4304
E-MAIL: hollyb@caminorealcs.org  
PHONE: 210-357-0359 or 357-0300
Apply