Job Description

Job Description

Job Description

Agency Profile: Spectrum Health & Human Services respectfully partners with adults, children, and families as they recover from behavioral, emotional, mental health and/or substance related disorders by offering individualized and meaningful opportunities of hope, empowerment and support to achieve self-defined improvements in their quality of life.

Full-time: 227 Thorn Avenue, Orchard Park, NY

SUMMARY OF POSITION FUNCTION:

Responsible for organizing, coordinating and monitoring all billing related activities. Coordinates communication between the team members and internal staff as well as external vendors. Maintains financial records for client and payer related activity. Is responsible to ensure compliance with all applicable federal, state, program regulations and payer rules.

MAJOR DUTIES AND RESPONSIBILITIES:

• Directly supervises the Billing Specialist(s) & other department positions
• Monitors or prepares all fee for service billing to ensure regulatory compliance and adherence to agency submission timeframes
• Ensures Account Receivable balances are within an acceptable range and if not implements steps necessary to effectively improve
• Monitors all private fee balances and reports compliance with agency Billing Policy and Procedure to Program Directors and Clinical Supervisors
• Monitors payments, denials and write-offs ensuring they are posted accurately and within the required time frames
• Reconciles all client account issues
• Is responsible for ensuring fiscal closings and all billing software related functions are completed in the required timeframe
• Works with site office staff to ensure that all insurance information, procedures and rules are current and adhered to
• Is responsible that all coding, pricing and authorizations updates are accurately reported to the Managing Director of Billing & Support Services for programming into the Cerner software
• Works directly with the Managing Director of Billing & Support Services on any internal or external audits
• Provides standard and requested reports to the finance or clinical departments monthly, quarterly, annually or as needed
• Adheres to Code of Ethics; reports all concerns and violations to management staff and/or Compliance Officer

SKILLS/COMPETENCIES:

• Working knowledge of all New York state Billing Regulations related to agency programs
• Familiarity of New York state insurance policies, including but not limited to Medicaid
• Familiarity with federal payers including but not limited to Medicare
• Working knowledge of legal requirements related to Accounts Receivables
• Excellent interpersonal and communication skills both verbal and written with the ability to make successful contacts, establishing relationships to obtain information necessary for the programs to function efficiently within the agency
• Meticulous documentation/recording skills with attention to detail; including excellent time management
• Requires strong organizational skills
• Ability to handle multiple tasks simultaneously
• Advanced competency in the use of computer software such as MSWord, Excel, Power Point, Outlook, etc.
• Cerner Millennium experience preferred, other electronic health records systems acceptable
• Ability to operate office equipment

EDUCATION REQUIREMENTS:

• High School Diploma or equivalent, Associates Degree preferred

EXPERIENCE:

• Five (5) years related experience in the medical billing field
• Minimum two (2) years supervision experience
• Must possess a valid Driver’s License with an acceptable driving record.

COMPENSATION: $59,500/yr - $75, 900/yr

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