General Statement of Duties:
Performs a variety of moderately complex reimbursement and Accounts Receivable tasks. The position requires exceptional attention to detail, intermediate spreadsheet and financial software skills, the capacity for handling a high volume workflow that may involve competing demands, and the ability to adapt to new work procedures and new situations, as well as maintaining client confidentiality. The incumbent closely coordinates work assignments and responsibilities with the Controller. This position reports to the Reimbursement Supervisor or to the Controller in the absence of Reimbursement Supervisor.
This position is classified non-exempt under the provision of the Fair Labor Standards Act.
Major Essential Functions:
- Job duties will evolve and may change based on agency demands.
- Daily, works insurance notifications with other medical billing/accounting professional as alphabet has been divided.
- Daily applies client and third party payments, insurance remittances, etc. to clients’ accounts in Electronic Health Record system.
- Pursues unpaid/outstanding claims, delays, denials, or other problems in payment of designated payers. Identifies and resolves billing problems and account discrepancies. Contacts third-party payers to verify eligibility, check claim status, and/or follow up on outstanding claims.
- Maintains up-to-date knowledge of third-party and other payers’ requirements in order to assist with notifications within the electronic health record and maximize reimbursements from those sources of revenue.
- Applies client payments received through intake and/or mail to account in Credible. Works with staff to reconcile missing items from the deposit during intakes.
- Prepares AR statements monthly for distribution.
- Works with Insurance Reimbursement Specialist to reprocess billings as needed.
- Prepares client refunds for approval by Controller.
- Serves as the primary back up to the Reimbursement Liaison position for financial intakes which included conducting financial interviews, sets fees, collects fees, complete fee agreement and fee appeals. Maintains documentation required for accounts. Explain insurance billing and the process.
- Assists in the collection procedures of client overdue accounts (legal action, set-off debt).
- May prepare and send necessary paperwork to maintain CSB information with the state Set-Off Debt (SOD) Collection program, including processing Add, Change, and Update Forms.
- May transmit SOD file to VA Dept. of Taxation and reconcile CSB SOD list with State SOD list. After match, may send official taxation letter and CSB discount offer letter to client.
- Maintains and supports internal controls for all activities in the Reimbursement Area including account receivable, collections, write-offs and any other activities as identified.
- Maintains current knowledge of insurance companies’ requirements and other payers in order to maximize the reimbursements from those respective sources of revenue and assist with notifications within the electronic health record.
- Maintains effective relationships with co-workers and clients based on courtesy, compassion, and respect.
- May back up other departmental functions or perform other duties and special projects as assigned consistent with established operational policies and procedures.
Required Knowledge, Skills and Abilities:
- Technical knowledge of medical billing, reimbursement, and accounts receivable practices, with emphasis on managed care and third-party payment requirements.
- Knowledge and navigation of billing system including reporting, preferable experience with Credible.
- Technical knowledge of Medicaid, Medicare, and other third-party payer requirements & regulations, procedures, and systems.
- Work independently, coordinate responsibilities and assignments of others at the appropriate level. Ability to seek and use supervision appropriately.
- Make decisions and initiate action based on established policies and procedures.
- Ability to explain complex payment/billing issues in an understandable manner to others who don’t have the billing knowledge.
- Demonstrate knowledge of computer operations in automated accounts receivable systems, office procedures and equipment; Excel-intermediate
- Perform detailed work in an accurate, efficient, and professional manner.
- Provide excellent customer service internal and external.
- Ability to understand and follow oral and written directions.
- Strong organizational, communication-both oral and written and interpersonal skills.
- Ability to be a team player within the department, agency and external to others. Flexibility with work duties.
- Maintain confidentiality of client and staff at all times.
Minimum Educational Experience:
Completion of high school or GED, preferably supplemented by college or business school courses; plus two years progressively responsible experience in relevant administrative support work, including reimbursement and third-party billing experience, OR any equivalent combination of training, experience, and aptitude that provides the required knowledge, skills and abilities.
Equipment: PC and designated software, adding machine/calculator, copy machine, fax machine, printer, document scanner, and telephone system.
Work Environment: General office environment with normal lighting levels, temperature ranges, air quality, ventilation, and noise levels.
Work Location: 1241 North Main Street Campus, Harrisonburg, VA
Work Hazards: Some hazard associated with repetitive motion necessary for data entry/ typing; standard hazards associated with human services environment.
Work Schedule: Monday through Friday, 8am to 5pm; additional hours as needed to perform job requirements. Regular attendance in person is required. This position is required to take at least five consecutive days of leave each year.