Under the general direction of the Quality Assurance (QA) & Billing Coordinator, this position is responsible for submitting and tracking Service Authorizations; reviewing and tracking staff progress notes; maintaining timely filing, organization, and confidentiality of client files; ensuring prompt and accurate billing for all client services; and carrying out requests for information in accordance with HIPAA law. The Billing Manager must possess attention to detail; organizational skills; knowledge of HIPAA law, Medicaid requirements and billing practices; and must be self-motivated.
This is an on-site position requiring residence in Sitka. In the interest of time, please do not apply if you are unable to relocate.
Essential Job Functions
- Checks and reviews all progress notes to make sure they meet the State requirements for billing.
- Enters and submits weekly Medicaid billing through the Allscripts Payerpath system and Private Insurance.
- Generates monthly invoices to bill parent(s) whose child is receiving services that are being paid for out of pocket. The invoice should list all billable services to be provided for the coming month.
- Tracks payments received for services paid out of pocket by parents.
- Reviews weekly Remittance Advice to investigate/re-bill any denial claims, addresses client eligibility issues, and submits breakdowns of weekly reimbursement by month and program. Informs supervisor, Executive Director, and Bookkeeper.
- Files all Remittance Advices according to agency and State regulations.
- Sets up private insurance contracts and submits accurate billing.
- Tracks any payments received from private insurance.
- Submits and tracks Service Authorizations in line with individual client Treatment Plans.
- Files all Service Authorizations according to agency and state regulations.
- Reviews and tracks the submission of progress notes for all agency programs to ensure timely completion.
- Compares billing sheets with progress notes to verify that the correct times and services are billed.
- Provides information to supervisors regarding staff billable and non-billable contact hours, as requested.
- Cross-trains in Quality Assurance and Billing responsibilities. Demonstrates ability to process and review documents in the absence of the Quality Assurance Manager.
- Provides information to supervisor for updates needed in the Billing and Quality Assurance Policy and Procedure manual.
- Learns and follows agency, Medicaid, State, and Federal regulations and requirements.
- Attends weekly meeting related to billing and brings any concerns to the attention of the department supervisor.
- Performs other related work as assigned.
- Available to assist and train staff in navigating AKAIMS.
Knowledge, Skills, and Abilities
- Organizational skills
- Attention to detail
- Consistency and reliability in performing routine duties
- Knowledge of agency policy, State Requirements, Federal regulations, Medicaid regulations, and HIPAA law
- Able to problem-solve independently
- Understands and demonstrates the importance of maintaining client confidentiality
- Able to communicate effectively with co-workers
Licenses and Certificates Needed
- Must be able to successfully pass State of Alaska Background Check
- Must be able to successfully pass TB Test (current)
Minimum Qualifications
- Experience with computers and Microsoft Excel
- Experience working with confidential documentation preferred
- Data entry/accounting experience preferred
- Medical billing experience preferred
Job Type: Full-time
Pay: $22.00 - $25.00 per hour
Expected hours: 40 per week
Benefits:
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Physical Setting:
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Experience:
- Microsoft Excel: 1 year (Required)
Location:
- Sitka, AK 99835 (Preferred)
Ability to Commute:
- Sitka, AK 99835 (Required)
Ability to Relocate:
- Sitka, AK 99835: Relocate before starting work (Required)
Work Location: In person