CTHCA Billing Specialist (CS-50110)

Closing Date: Open Until Filled bi-weekly review

Position: Billing Specialist

Salary: $23.32 - $28.40

Reports To: Revenue Cycle Supervisor

Location: LRCHC Inchelium, WA

SUMMARY:

Performs billing and claims processing functions to support timely and accurate reimbursement for healthcare services. Ensures compliance with federal, state, tribal, and payer regulations while maintaining confidentiality and providing excellent customer service to internal and external stakeholders.

Qualifications

KNOWLEDGE, SKILLS, AND ABILITIES:

• Requires knowledge of medical terminology, anatomy and pathophysiology, medical and behavioral health services, provider specialties, and insurance terminology.
• Requires current knowledge of third-party billing regulations and ability to stay up to date with regulations.
• Requires the knowledge to maintain working knowledge of current changes in coding and billing requirements from Medicare, Medicaid, and other third-party payers.
• Requires a working knowledge of the practices, procedures, and terminology of medical claims processing.
• Requires a working knowledge of office clerical procedures and computer-aided office productivity software.
• Requires sufficient writing skills to prepare basic business correspondence.
• Requires sufficient math skills to compute totals, extensions, portions, ratios, quotients, and percentages.
• Requires sufficient human relations skills to convey policies and procedures and to deal cooperatively with others on accounting transactions.
• Requires the ability to perform the functions of the position.
• Requires ability to apply and review diagnostic and procedural coding utilizing approved coding tools including but not limited to current coding textbooks.
• Requires ability to effectively operate computer and software applications associated with office requirements as well as Revenue Cycle Management.
• Demonstrates the ability to undertake multiple tasks and follow through to completion.
• Requires ability to complete assigned workload accurately and dependably with minimum supervision.
• Requires ability to communicate effectively verbally as well as in writing.
• Requires ability to analyze and effectively solve problems.
• Requires ability to provide reports on assigned program account regarding unpaid balance, denials, adjustments, and provider activity quarterly, or upon request of Centralized Billing Supervisor, or program managers.
• Requires the ability to maintain strict confidentiality in compliance with HIPAA standards.
• Requires the ability to research, compile, analyze, and interpret claims data.
• Requires the ability to maintain accurate and retrievable files, records, audit trails, and trace transactions to original entries.
• Requires the ability to perform accounting and general math computations quickly and accurately.
• Requires the ability to organize and prioritize work to meet deadlines and timetables.
• Requires the ability to work cooperatively and professionally with customers, staff, tribal government personnel, and outside agency personnel and vendors.
• Requires the ability to access and use a computer, common office productivity software, and specialized accounting software to access databases.

Note: Pursuant to Tribal Policy, if this position is safety sensitive it is subject to pre-employment drug testing. In addition, this position is subject to reasonable suspicion and post-accident drug testing.

TRIBAL MEMBER AND INDIAN PREFERENCE WILL APPLY; PREFERENCE WILL ALSO BE GIVEN TO HONORABLY DISCHARGED VETERANS WHO ARE MINIMALLY QUALIFIED.

If required of this position, you must possess and maintain a valid Washington State driver’s license and be eligible for the Tribes’ Vehicle Insurance. In addition, this position may be subject to pre-employment background clearances. If applicable, these clearances must be maintained throughout employment.

INFORMATION: Carla Spencer, HR Recruiting Manager, Colville Tribal Health Care Authority, Human Resources Office, P.O. Box 150, Nespelem, WA 99155, (509) 846-3774. carla.spencer.hca@colvilletribes.com