Billing Clerk

A. ORGANIZATIONAL RELATIONSHIPS Position Title: Billing Clerk 1-FIS011 Work Unit: AACSB Administration County: Dougherty Immediate Supervisor's Title: Billing Manager and Revenue Cycle Management Director B. QUALIFICATIONS Knowledge of basic accounting, data entry, balancing accounts, ability to follow processing guidelines according to agency procedures, and ability to use appropriate software (MS Office, EMR). Ability to handle money and checks, skills in basic math, and ability to address patients/customers courteously and professionally. Knowledge of billing policies and procedures. High school diploma. One or more years of experience 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 a 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. BLOOD BORNE PATHOGEN CATEGORY 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 do not involve exposure to blood or other potentially infectious matter, but employment may require performing unplanned Category I tasks (Category II). Employee performs assigned tasks which involve no exposure to blood or other potentially infectious material and performance of Category I tasks is not a condition of employment (Category III). E. MANDATORY TRAINING CATEGORY Administrative Direct Care Medical F. PERFORMANCE IMPROVEMENT The Albany Area Community Service Board goal is to continually improve the delivery of service by improving 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. G. ASSIGNED DUTIES Entering and processing claim data Provide ongoing/on‑call operational and end‑user assistance. Analyze and resolve problems on a local level in an accurate and timely manner. Post and track payments. Communicate with providers regarding progress in resolving billing issues. Generate and send client statements monthly. Enter financial or billing information into 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 with questions regarding their statements or account. Answer calls from local administrators and/or users in a timely, efficient, and professional manner. Document problems and resolutions within the agency support system. Listen to end‑users and maintain a professional business relationship. Entering and processing all billing data for Developmental Disability Participants (if assigned) Calculate data and complete monthly reports of DD services for CEO and state‑required reports. Track authorizations and notify appropriate staff via email 30 days before expiration; alert when units are depleted and new authorizations are needed. Work with managers and supervisors to assist with all billing and authorization problems, reaching resolution in a timely manner. Download and file assigned insurance each week no later than the Friday of the week and post payments. Communicate with insurance providers to resolve billing issues and report to appropriate staff and CIMO of all issues that will cause claim rejection, coding errors, or modifier issues. Work insurance denials to reach resolution within 5 days from the date the RA is received; alert appropriate staff of needed changes or corrections and follow through to ensure claim is resubmitted within the time limits for each insurance provider. Notify immediate supervisor if problems are not resolved within 5 days. Entering and processing all billing data for non‑DD claims (if assigned) Extract, enter, and work insurance denials to reach resolution within 5 days from the date the RA is received; alert appropriate staff of needed changes or corrections and follow through to ensure claims are resubmitted within time limits. Work with managers and supervisors to assist with all billing and authorization problems, reaching resolution in a timely manner; notify immediate supervisor if problems are not resolved within 5 days. Medical Records Support Provide support to the Medical Records Department by releasing medical information orally or in written format. Obtain 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 the area of assignment, compiles data, prepares and distributes billing/claim requests, bank deposits, and 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 to compute fees and charges due. Operates computers programmed with accounting software to record, store, and analyze information. Reviews files, records, and other documents to obtain information to respond to requests. #J-18808-Ljbffr