Job description

Position Summary: This position has responsibility for and oversight of all Medicare and Medicaid billing, as well as other billing functions necessary to maximize reimbursement for services across the agency. Additionally, the position is responsible for properly coding cash receipts against outstanding accounts receivable due from a variety of funding sources for organization-wide programs.

Essential Functions:

1. Prepare, compile, and submit all Medicaid billing for the agency according to the prescribed billing schedules.

2. Prepare, compile, and submit all Provider Connect billing for the agency according to the prescribed billing schedules.

3. Perform ongoing QA functions on all reimbursement files prior to and after initial submission; work with case managers and service providers to ensure the capture of all services.

4. Reconcile payments received with initial submitted billing and resubmit as necessary.

5. Monitor all incoming reimbursements from county and state to ensure all reimbursements are received.

6. Investigate and resubmit any denied or unaccepted claims.

7. Function as liaison between WCS and funding sources (i.e., Medicare and Medicaid, private insurance companies, the county, etc.) as needed.

8. Monitor changes in state Medicaid/Medicare rates for impact on WCS clinical rates.

9. Prepare all 1/12th invoices in accordance with funding source contracts.

10. Perform all Synthesis billing and follow-up activities.

11. Determine proper coding and correctly apply cash receipts to outstanding receivables.

12. Monitor status of open receivables and work with Senior Accountants to follow up on overly-aged amounts due.

13. Assist Controller and CFO with administrative tasks (i.e., scheduling meetings, sending communications, printing reports, etc.)

14. Review all available written materials and attend in-services to main current with billing rules.

15. Participate in and oversee appropriate training of service staff on correctly entering information into database to ensure proper billing.

Other Duties and Responsibilities:

1. Attend clinical staff meetings as needed.

2. Collaborate with program staff to ensure compliance with billing procedures.

3. Other job-related duties as may be necessary to carry out the responsibilities of the position.

Work Relationship and Scope: Reports directly to the Accounting Supervisor. Has contact with a wide variety of individuals including staff, insurance payors, and auditors.

Personal Attributes: Follow agency Code of Conduct; adhere to established policies and procedures of the agency and of all funding sources; conduct self in an ethical manner; maintain professional and respectful relationships with program staff, other WCS staff, clients and all external persons and agencies involved with service provision; sensitivity toward cultural, ethnic and disability issues; demonstrate commitment to agency values and mission.

Knowledge, Skills and Abilities: Good understanding of accounting best practices; computer proficiency with Microsoft Word and Microsoft Excel is required; familiarity with the CSP Exchange, Forward Health portal and Provider Connect is preferred; fast and accurate data entry, including use of 10 key calculator; good organizational skills and the ability to multitask; professional communication skills; ability to meet deadlines; some knowledge of mental illness and the ability to work with individuals diagnosed with mental illness.

Working Conditions: Work is performed primarily in an office environment; most of the work is done sitting at a desk and using the computer; 40 hours per week.

Physical Demands: Work is sedentary in nature and requires sitting for long periods of time with occasional trips to the printer and copier; hand and finger dexterity for data entry and 10 key.

Minimal Qualifications and Salary Schedule: Associate’s Degree in accounting, business or medical billing, or equivalent experience; understanding of aspects of Medicare/Medicaid billing process related to services provided by WCS.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Paid time off
• Vision insurance

Physical setting:

• Office

Schedule:

• Monday to Friday

Education:

• Associate (Preferred)

Experience:

• Medicare/Medicaid Billing: 1 year (Preferred)
• CSP Exchange, Forward Health portal and/or Provider Connect: 1 year (Preferred)
• data entry: 1 year (Preferred)
• working with individuals diagnosed with mental illness: 1 year (Preferred)

Work Location: One location

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