Division: Community and Family Services, Family Support Program
Job Code: 29-2071
Status: Full-time, permanent, non-exempt
SUMMARY: This position is responsible for the implementation of the Electronic Health Record (EHR) and all aspects of billing relating to Home and Community Based Services, as well as ongoing management and maintenance ensuring data integrity, compliance, proper utilization and maximum revenue reimbursement.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:
At all times, serve as an advocate for the consumer with whom you work.
Responsible for planning, coordinating and administering the daily functions of all Electronic Medical Records and addressing all staff questions to include the maintenance of systems to ensure that they are always running at maximum speeds, fully functional and accessible at all times to all staff who require the use of them.
Manages the Disaster Recovery efforts of all Electronic Medical Record systems.
Coordinates and provides ongoing training on Electronic Health Record for all employees as well as orientation coordination for all new employees utilizing the systems.
Responsible for establishing and maintaining a complete electronic medical record for each program participant in accordance with regulatory and professional standards, including, but not limited to, seeing that medical records are completely documented and properly organized, easily accessible to facilitate retrieval of information, coded to conform to all state and federal standards.
Assists and provides data from all electronic medical record systems for audits and study projects involving p care and utilization of services.
Responsible for managing and maintaining an ongoing routine audit schedule for all records which would include participation in continuous quality improvement activities directly related to oversight of EHR.
Keeps current with state and federal regulation changes relating to medical records and Medicaid billing.
Leads EHR development and optimization projects to improve clinical and financial workflows and manages tasks therein.
Investigate pending claims and resolve discrepancies via phone, insurance portals, via fax, etc. Resolve claims rejections in a timely fashion and monitor payer acceptance of claims;
Manages and ensures each claim to an appropriate and successful resolution.
Submits initial and corrected claims in adherence with a schedule that supports timely billing and maximizes the Medicaid claiming cycle.
Other related duties as assigned.
Gather and process information needed to complete claims for payment.
Determine why a claim was denied and resolve claim denials within established time frames.
Track rejected, denied, appealed, and corrected claims to ensure payment.
Identify claims needing corrections and resubmit following proper methods and time lines.
Responsible for maintaining current billing, coding, and standard operating procedures (SOP) files as a desk reference.
SUPERVISORY RESPONSIBILITIES: There are no supervisor requirements for this position.
QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE: High School Diploma with 1 – 2 years of experience and training in the area of Medicaid billing and/or Electronic Health Record management. Certification in the area of EHR management, familiarity with federal and state Medicaid billing practices preferred.
OTHER SKILLS and ABILITIES: Strong oral and written communication skills required. Must have excellent computer skills including word, excel, and experience with varying databases. Computer testing in the applicable skills may be a requirement during the interview process.
This position mandates employees to report to or remain at work in the event of an emergency, crisis situation or staff shortage until relieved by their immediate supervisor.
REASONING ABILITY: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Applicants must submit letter of interest, resume, supporting documents (certificates, degrees, licenses) and proof of native preference eligibility (Tribal Identification Card or Status Card or letter) by email to email@example.com or by mail to Human Resources, Saint Regis Mohawk Tribe, 412 State Route 37, Akwesasne, NY 13655. Due to our network security, we are unable to open hyperlinks. Applicants will need to attach their documents as PDF or WORD files if emailing. Applicants must clearly outline that they meet the qualification requirements on their resume.
NATIVE PREFERENCE POLICY
The Saint Regis Mohawk Tribe strives to be an equal opportunity employer dedicated to the policy of nondiscrimination based on race, sex, marital status, sexual orientation, religion, national origin, age, physical disability, veteran status or any other non-job related factor. Among qualified applicants, the SRMT will give preference to the qualified native applicant.
DRUG TESTING POLICY
The successful applicant for employment must submit to and pass a drug test for illegal substances prior to employment being confirmed.
Some positions require candidate(s) to successfully pass a criminal background check prior to beginning employment, used solely for employment related purposes.
A list of qualified candidates is created from interviews that may be used to appoint individuals to similar positions within the Saint Regis Mohawk Tribe for a period of six months.
Testing in the applicable skills may be required as part of the interview process.
About Saint Regis Mohawk Tribe
The Saint Regis Mohawk Tribe is the duly elected and federally recognized government of the Akwesasne Mohawks that deals exclusively with the United States and the State of New York in all government-to-government relations. Its vision encompasses the shared desire to improve and enrich the lives of tribal members, while leading the Akwesasne community into the future with confidence and the strength of traditional Mohawk core values.
The SRMT provides competitive salaries and comprehensive benefits including medical/dental plans, short term/long term disability coverage, 401k plan with discretionary company contribution, paid time off, group life insurance coverage, resources and more!