Position Summary and Job Duties
Performs general accounting duties to support the Revenue Cycle Management tasks of the Human Services Department. This includes charge maintenance; billing preparation and submission; data correction; interface for clients, staff, and third-party payers; denial management and claim resubmission. Supports and promotes the Mission, Vision and Guiding Principles of the Human Services Department. Performs in a manner consistent with the HSD Professional Standards and Commitment to My Co-Workers.
40% – Charge Maintenance
- Create weekly extractions of program staff documentation summaries from electronic health record and distributes reports to supervisors to ensure episode notes are entered prior to billing to payers
- Review and add provider credential modifiers for billing software to assign appropriate charge amounts
- Initiate billing system data updates to apply missing and corrected data
- Review and correct errors and omissions in episode entries (diagnosis codes, time durations, charge roll-ups) through program staff e-communications
- Inform revenue cycle coordinator monthly of reoccurring billing data entry mistakes so appropriate training can be encouraged
20% – Billing Preparation and Submission
- Prepare and submit claims for services to third-party payers
- Prepare and issue invoices to private-pay clients
- Prepare and mail monthly statements to clients with outstanding balances
- Create monthly A/R aging report and provide to revenue cycle coordinator
20% – Data Correction
- Modify client insurance information to direct billing to appropriate payers
- Correct episode notes (Records Quality Management)
- Correct addresses on returned mail in billing system
10% – Billing Denial Management
- Determine the billable charges for each third party payer and maintain clients’ payer files in billing system to reflect those services
- Inquire regarding denial of payment from third party payers
- Resubmit corrected claims to third-party payers
5% – Interface for Clients, Staff, Third-Party Payers
- Initial contact for inbound phone calls from clients and third-party payers for billing questions
- Create past month’s program staff documentation summaries and distribute to supervisors, revenue cycle coordinator, and business manager
5% – Other duties as assigned
- Allocate monthly Motor Pool mileage into summarized data by program for journal entry creation
- Allocate monthly cell phone charges into summarized data by program for journal entry creation
- Bill Job Center tenants for phone and copier usage
- Aid unit with check reconciliations, scanning, filing
Success Factors (KSA’s)
- General knowledge of bookkeeping (creation of journal entries, Accounts Receivable functions and reporting), office procedures and terminology
- Excellent analytical, computational, and basic math abilities
- Proficient in computer skills, including MS Outlook, MS Word, MS Excel, and accounting software
- Proficient data entry skills with attention to detail
- Understanding of Human Service programs, HIPAA privacy standards, and trauma-informed care; need for level of integrity due to nature of work performed by department
- Professional verbal and written communication skills to represent department on phone and in written form
- Ability to interact with clients, staff, and payers to ensure accurate information and correct billing
Job Requirements, Education, Training & Experience
- High School diploma or equivalent supplemented by focused coursework in bookkeeping and software applications. Three-four years of bookkeeping or accounting experience, or associate’s degree or higher with 1-2 years of bookkeeping experience.
Essential Job Functions (physical elements, equipment and working conditions)
Physical elements:
- Employee is regularly required to stand, sit, talk, hear, and use hands and fingers to operate a computer and telephone keyboard
Equipment use:
- Ability to use desktop computer and keyboard
- Ability to use standard office equipment
Working conditions:
- Low noise level in an office setting