Revenue/Resource Division Manager

CONFEDERATED SALISH AND KOOTENAI TRIBES

OF THE FLATHEAD NATION

PO BOX 278

PABLO MT 59855

(406) 675-2700

PERSONNEL OFFICE FAX: (406) 226-2562

E-mail melanie.piedalue@cskt.org

WEBSITE ADDRESS: csktribes.org

TITLE: Revenue/Resource Division Manager

LOCATION: Tribal Health Department – Location negotiable

SALARY: $33.79 to $38.84 per hour, plus benefits

May be employed under contract

CLOSING DATE: Thursday, February 6, 2025 at 5:30 p.m. MST

SPECIAL CONDITIONS:

This is not a Testing Designated Position (TDP) within the definition of the CSKT Drug Testing policy. The

successful applicant, if not already employed by the Tribes must pass a pre-hire drug test and serve a

mandatory six (6) month probationary period.

The Revenue/Resource Division Manager is a senior management position in the THD Department

responsible for developing and implementing business and management procedures related to the billing and

collection function for medical services provided to beneficiaries of the Tribal Health Department. Some

beneficiaries have an alternate payment resource such as Medicaid, Medicare, private insurance and/or

Veterans Medical Benefit and some do not. Some of the benefits are seasonal in nature. The position

requires a dedication to the billing and collection function as federal funds provided by the Indian Health

Service are not sufficient to provide for the beneficiaries. The staff is consistently verifying and re-

verifying patients alternate resources, potential payers and conditions for payment.

Specific duties include, but are not limited to:

• Monitors and interacts with clinicians to identify methods for tracking issues associated with the

processing of a billable claim for each patient visit

• Interpretation and implementation of rules and regulations on programs administered by the federal

department of Health and Human Services/CMS.

• Transmission of claims on behalf of the Tribes billing third party resources including Medicaid,

Medicare, Veterans Medical Benefit Insurance, and private insurance.

• Effective communication in person, by mail, or electronically with various federal, state and local

governments pertaining to programs services and eligibility.

• Communicates personally, by mail, or electronically with various hospitals, clinical providers, and

patients or services and reviews eligibility for services for patients eligible for third party coverage.

• Analyzes and determines when new payers are added to the third party group and must be capable

of securing all approvals for billing which improves the revenue position of THD.

• Completion of all requirements related to obtaining financial reimbursements from all insurances

including analysis and recommendation for approval of network agreements.

• Audit Medicaid claims submitted assuring accuracy and timeliness to state for reimbursement.
  

• Evaluates departmental capacity to perform services under approved state plans and provide

recommendations to Director for necessary adjustments to meet needed criteria for reimbursement.

• Establish scopes of work, internal operating procedures, and work productivity standards for third

party billing, payment posting, financial and statistical reporting and beneficiary services.

• Periodically audits THD claims from billing, to payment posting and posting to the general ledger at

CSKT Tribal government in Pablo. The goal is to assure necessary and reliable internal controls as

well as fund balance.

• Implements procedures to challenge denials of payments for medical services.

Remains informed about the implications of the ACA and how that impacts billing and collections

for Tribal governments/patients.

• Insure production of financial and management reports with appropriate, timely and accurate

analyses and projections for the Department on a monthly basis or as requested.

• Perform other duties as assigned.
  

MINIMUM RECRUITING QUALIFICATIONS AS REFLECTED ON TRIBAL EMPLOYMENT

APPLICATION:

• Associates Degree in business administration; medical administration, health

administration or computer sciences

• Must have a minimum of three years professional experience working in a

Medicaid billing/auditing position;

• Must be knowledgeable of Medicaid program, eligibility requirements and rule

Concerning reimbursements;

• Must be familiar with Tribal operations and capacity to file claims for services

under State Medicaid Plan, Veterans Insurance, and other private insurance payers;

• Must have demonstrated experience in filing appeals for denied services;
  

DESIRABLE QUALIIFICATIONS (AS DETERMINED BY THE INTERVIEW):

• Request a copy of position description for full details.
  

SUBMIT:

1. Completed Tribal employment application.

2. Copies of relevant degree/academic transcripts, training certificates, and licensure.
3. Copy of a current valid driver’s license.
4. Proof of enrollment in a federally recognized Tribe if other than CSKT.
5. If claiming veteran’s preference, a copy of the DD214 must be submitted.

FAILURE TO SUBMIT ALL OF THE ABOVE INFORMATION WILL RESULT IN IMMEDIATE

DISQUALIFICATION DURING THE SCREENING PROCESS

SUBMIT ALL OF THE ABOVE TO: Personnel Office, PO Box 278, Pablo MT 59855, telephone (406)

675-2700 Ext. #1040 or personnel@cskt.org

FOR MORE INFORMATION:

Contact Joe Durglo at 406-675-2700 ext. 5026