Job Summary: Performs a variety of billing functions that include the preparation and distribution of invoices, processing payments, and payment approval. Analyzes billing data and prepares reports for revenue and expenditures. Collects state Medicaid and state funding reimbursements by gathering, coding, and transmitting patient information; resolving discrepancies; adjusting patient bills; preparing reports.
Essential Functions: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Gathers billing information by reviewing client records; checking for completeness.
- Provides billing information by collecting, analyzing, and summarizing third-party billings, accounts pending, and late charges data and trends.
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Bills insurance carriers by inputting billing information to database; initiating electronic transmissions to the assigned payers at a minimum of once per week.
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Ensures payments by verifying accuracy of insurance coding.
- Performs job responsibilities with minimal supervision.
Teamwork and Cooperation
- Cooperates with others to accomplish common goals; works with employees within and across her department to achieve shared goals;
- Treats other with dignity and respect and maintains a friendly demeanor;
- Values the contributions of others.
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Maintains focus on Agency goals and mission.
Research
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Researches/resolves problematic transactions and disputed claims by gathering, verifying, and providing additional information; following-up on claims.
- Resolves discrepancies by examining and evaluating data; selecting corrective steps.
- Adjusts patient bills by reviewing remittance advice; consulting with insurance office and process refunds as needed.
- Runs the Aging Report once per week to resolve/research any outstanding claim over 90 days.
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Process billing corrections sent in by staff.
Required Knowledge & Skills
Ability to use appropriate software
Ability to create and/or maintain reports
Ability to Analyze Information
Ability to process payments and/or refunds in accordance with established guidelines
Ability to file third party payer claims
Ability to maintain accurate records
Ability to Pay Attention to Detail
Ability to communicate effectively, both orally and in writing.
Ability to answer telephone, direct calls and take messages.
Ability to assist and answer staff questions.
Ability to open, sort and route incoming mail, answers correspondence and prepare outgoing mail.
Ability to determine the consumers issues with billing and handle accordingly.
Ability to make decisions with regard to job assignments and manage office workload.
Ability to greet the public and work well with others.
Ability to prioritize duties and meet deadlines.
Ability to maintain filing system.
Ability to compose correspondence that is both concise and professional.
Ability to check reports for accuracy.
Ability to prepare agency specific forms.
Ability to collect information gathered to prepare reports and/or presentations.
Ability to type at a proficient level and speed.
Ability to troubleshoot office equipment.
Knowledge of various agency related programs (such as Beacon/Carelon, GAMMIS,GA DCH/Medicaid, etc…)
Knowledge of basic accounting/ and bookkeeping processes
Knowledge of billing system and procedures
Knowledge of agency specific billing/transaction guidelines, procedures, and codes
Knowledge of general office procedures including typing, filing etc.
Knowledge of agency and departmental policies and procedures.
Knowledge of office software i.e. Microsoft Office.
Knowledge of the Open Records Act.
Knowledge of agency specific forms.
Knowledge of scheduling software.
Knowledge of departmental needs.
Knowledge of agency policies and procedures.
Knowledge of agency and state specific software.
Knowledge of supervisory styles, techniques, and models.
Skills in problem solving and problem resolution
Skill in Customer service
Skills in office administration (filing, etc.)
Data Entry Skills
Quality Focus Skills
Productivity
Time Management
Financial Skills
Reporting Skills
Competencies:
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Decision Making
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Organizational Skills
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Results Driven
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Problem Solving
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Customer Service
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Ethical Conduct
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Cooperation and Collaboration
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Accountability
Financial Awareness
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Required Education & Experience: High School Diploma & AND Two years of billing service experience. Therap software experience a plus.
Supervisory Responsibilities: N/A
Work Environment: General office environment. Employee is frequently required to walk, sit, stand or kneel and occasionally required to climb or balance and stoop. Employee must occasionally lift and/or move up to 25 pounds. Must have ability to sit for long periods of time at a computer. Lighting and temperature are adequate, and there are no hazardous or unpleasant conditions caused by noise, dust, etc. Employee must be able to travel between Gateway sites if needed to assist in training staff.
Gateway CSB promotes a drug/alcohol free work environment through the use of mandatory pre-employment drug testing.
