Position Summary:

Responsible for assisting the Revenue Cycle Director in leading and supervising the daily operations and administration of Revenue Cycle functions, including Coding, Billing, Accounts Receivables, and Payment Processing, within three GRHC campuses and multiple IT platforms. Helps ensure accuracy, timeliness, and compliance of reimbursement activities by identifying trends in payer reimbursement and monitoring changes in regulations and policies. Leads revenue cycle provider education development and rollout throughout the organization for billing and coding. Works with the Revenue Cycle Director to evaluate payers and facilitate contract negotiations for the most favorable rates.

Critical Tasks:

Assists in the daily operations of the Revenue Cycle Billing, Coding, Accounts Receivable, and Payment Posting teams. Prepares and presents monthly revenue and budget projections to the Revenue Cycle Director; identifies trends and escalates issues as they arise. Implement and maintain an internal audit function within RCM to monitor and increase accuracy within all RCM functions. Develops, implements, and monitors key performance indicators (KPI) to improve the revenue cycle which include, but may not be limited to, percent accounts receivable greater than 90 days and unbilled/uncoded totals. Maintains effective partnerships with other leaders, departments, and remote satellite locations of the hospital to improve operations and management of billing, coding, patient registration, compliance, and system integration. Leads the education program in coordinating with the Billing and Coding Manager to develop and implement an effective platform for internal and external providers. Coordinates with the Revenue Cycle Director to ensure the Revenue Cycle department is represented at external and internal meetings including standing in for the Director when they are unavailable. Ensure compliance with billing and coding federal regulations including critical access and tribal 638 specific regulations. Assist in the evaluation and implementation of new technologies or software to support revenue cycle functions. Other duties as assigned.

Required Qualifications:

Bachelor's Degree in Healthcare Administration, Business, Finance, or related field required. Minimum of 5 years of progressive experience in healthcare revenue cycle management, with at least 2 years in a leadership or supervisory role. Experience working with tribal health organizations, or similar healthcare systems strongly preferred. Strong knowledge of

HIPAA, CMS

billing regulations, Medicaid/Medicare, and private payer policies. Proficient with electronic health records (EHR) and revenue cycle management systems (e.g., Cerner, Nextgen, Epic, or similar) Certification in Healthcare Revenue Cycle (such as CRCR or CHFP) preferred. Demonstrates ability to relate to diverse cultures and specifically the Gila River Community and/or other Native American cultures and community health services.