POSITION DESCRIPTION: This position is responsible for the billing of Medicaid and MCO fiscal intermediaries of BRIDGES, Inc. The position will provide financial reporting to the Director of Finance.
CLASSIFICATION: Non Exempt
QUALIFICATIONS:
General
- Associates Degree and at least two years’ experience in Billing
- Certification in Medical Billing/Coding preferred
- Two plus years of Medicaid billing preferred
- Knowledge of CPT and ICD coding
- Experience with billing systems software preferred
- Strong working knowledge of Medicaid and Medicare billing regulations and requirements
- Ability to use various software packages for accounting and billing systems; proficiency in Microsoft Office Suite of products
- Proactive, motivated and focused team-player attitude, self-sufficient and willing to go “above and beyond” on a regular basis
- Microsoft Word and Excel
- Able to handle highly confidential information
- Must be detail oriented and able to adhere to tight deadlines
DUTIES & RESPONSIBILITIES
- Ability to interact with co-workers, people we serve, elected officials and other agency staff, as well as the public in a professional and courteous manner
- Good written and oral communication skills
- Maintains and secures financial information by ensuring data confidentiality and integrity;
- Proficiency in Microsoft Word, Outlook Mail, Outlook Calendar, g-mail and g-docs
- Produce billing documents in the formats required by the program(s)
- Communicate with insurance companies regarding denials
- Validate insurance benefits for members
- Triage prior authorization rejections
- Follow up on prior authorizations that have been submitted with no response from the insurance carrier in a timely manner.
- Initiate appeals for denied authorizations, when justifiable.
- Maintain electronic and paper current and archival files of submitted billing documentation
- Maintains accounting spreadsheets and systems for all billings and receivables
- Ensures accurate billing and coding (ICD-9, CPT, etc.)
- Maintaining confidentiality by safeguarding the personal information of our staff, both by appropriate procedures in handling and filing paperwork as well as avoiding inappropriate discussions in public areas of the office. This confidentiality also extends outside of the office and regular office hours, to avoiding discussing names and any information about the people we serve with friends, family members or in any public place
All responsibilities for this position should be carried out with the Mission and Goals of the agency in mind; including interactions with people who come to us for assistance, members of the public, representatives from other agencies and county offices, as well as with co-workers in daily office functioning
- Complies with federal, state, and local financial legal requirements by studying existing and new legislation, enforcing adherence to requirements, and advising management on needed actions
- Maintains strict confidentiality and protects Agency operations by keeping information confidential and secured
- Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
- Adheres to all Agency policies and procedures, including but not limited to corporate compliance, personnel and fiscal policies and procedures
- Establishes and maintains a strong attention to detail, insuring work is accurate and complete, and adheres to all established deadlines
- Exercises good judgment with decision making and problem solving
- Effectively and professionally interacts with all levels of associates