Billing Clerk

Aspire Behavioral Health & Developmental Disabilities Services Job Description

A. ORGANIZATIONAL RELATIONSHIPS

Position Title: Billing Clerk 1-FIS011


Position Number:


Date:


Employee:


Work Unit: AACSB Administration County: Dougherty

Immediate Supervisor's Title: Billing Manager and Revenue Cycle Management Director

List positions supervised through immediate contact: None

B. QUALIFICATIONS:

Knowledge of basic accounting, data entry, balancing accounts, ability to follow processing guidelines according to agency procedures, ability to use appropriate software (e.g., MS Office, EMR), ability to handle money and checks, skills in basic math, ability to address patients/customers in a courteous and professional manner, knowledge of billing policies and procedures. High school diploma. One or more years of experience in working insurance and denials for effective resolution. Experience working with Electronic Medical Records. Two or more years in medical billing and collections. Functional knowledge of computer and Microsoft Office. Must work well in a team environment and independently.

Preference for: one or more years in State Contract Service Environment.

Preference for: one or more years working with Developmental Disability billing.

(Physical) No lifting of more than 20 pounds.

C. EQUIPMENT THAT REQUIRES SAFE AND EFFECTIVE USE:

(Include emergency equipment, treatment equipment and high risk equipment)

D. BL00DBORNE PATHOGEN CATEGORY (check one)

____Employee routinely performs tasks that involve exposure to blood or other potentially infectious material as part of their assigned duties (Category I).

____Employee performs assigned tasks which does not involve exposure to blood or other potentially infectious matter, BUT employment may require performing unplanned category I tasks

(Category II).

X Employee performs assigned tasks which involve no exposure to blood or other potentially infectious material AND performance of category I tasks are not a condition of employment

(Category Ill).

E. MANDATORY TRAINING CATEGORY (Check One)

_X__ Administrative

____ Direct Care

____ _

____ Medical

F. PERFORMANCE IMPROVEMENT

The Albany Area Community Service Board goal is to continually improve the delivery of service by improvement of consumer outcomes and satisfaction. All employees have a role in performance improvement and are expected to interact collaboratively with co-workers, and other contacts to provide consistent, high-quality, consumer focused services.

ALBANY AREA CSB Job Description Page 2

Position Title: Billing Clerk 1-FIS011


Position Number:

G. ASSIGNED DUTIES

Duties may include, but are not limited to:

1. Entering and process claim data:
   • Provides on-going/on-call operational and end-user assistance:
   • Analyzes and resolved problems on a local level in an accurate and timely manner.
   • Post and track payments.
   • Communicate with providers with progress in resolving billing issues.
   • Generate and send client statements monthly.
   • Enter financial or billing formation in clients accounts.
   • Work monthly aging reports for outstanding balances and resubmit corrected claims.
   • Resolve insurance authorizations and denials.
   • Submit appeals to insurance companies as needed to secure payments on claims.
   • Serve as point of contact for clients that have questions regarding their statements or account.
   • Answers calls from local administrators and/or users in a timely, efficient, and professional manner
   • Document problems and resolutions within agency support system
   • Listens to end-users and maintain a professional business relationship

1. Entering and process all billing data for Developmental Disability Participants (if assigned):

• Calculates data and completes monthly reports of DD services for CEO and State required reports.
• Tracks Authorizations and notifies by email appropriate staff when any consumers authorizations are going to expire (30 days ahead of expiration) and if units are depleted and new authorizations are needed.
• Works with managers and supervisors to assist with all billing and authorization problems and reaches a resolution in a timely manner
• Shares responsibility of downloading and filing assigned insurance each week and not later than Friday of each week and posting of payments.
• Communicates with insurance providers to reach resolutions for billing issues and reports to appropriate staff and CIMO of all issues that will cause a claim rejection, billing, coding and use of modifier issues and errors.
• Works insurance denials to reach resolution within 5 days from the date the RA is received. Alerts appropriate staff of needed changes or corrections and follows through to ensure claim is resubmitted within in the time limits for each insurance provider.
• Work with DD managers and supervisors to assist with all billing and authorization problems and reaches a resolution in a timely manner. Notify immediate supervisor if problems are not resolved within 5 days

1. Entering and process all billing data for non-DD claims (if assigned):
   • Extract, enter, works insurance denials to reach resolution within 5 days from the date the RA is received. Alerts appropriate staff of needed changes or corrections, and follows through to ensure claims is resubmitted within the time limits for each insurance provider.
   • Work with managers and supervisors to assist with all billing and authorization problems, and reaches a resolution in a timely manner. Notify immediate supervisor if problems are not resolved within 5 days.

ALBANY AREA CSB Job Description Page 3

1. Medical Records Support:

• Provide support to the Medical Records Department by releasing medical information in either oral or written format. Obtaining necessary releases from Individuals, following HIPAA regulations, to allow for the release of such medical information.

DUTIES INCLUDE:

Performs billing functions, completes required accounting documentation, such as batch reports, bank statements, and agency generated reports and/or related records. Enters financial transactions into accounting systems or files. Verifies and corrects accounting and financial information in area of assignment. Compiles data, prepares and distributes billing/claim requests, bank deposits, or related reports. Copies, distributes, receives and/or mails letters, bills, memos, statements of account, and other documents and materials. Maintains files and records. May make routine determinations of client ability to pay, review documents to compute fees or charges due, accept payments from customers, and/or apply payments to existing accounts. Completes and mails bills, invoices, and other financial documents. May review documents such as purchase orders, invoices, or hospital records in order to compute fees and charges due. Operates computers programmed with accounting software to record, store, and analyze information. Review files, records, and other documents to obtain information to respond to requests.

NOTE: This position will answer directly to the

Position Title: Billing Manager and Revenue Cycle Management Director