FISCAL ASSISTANT I

The State Personnel System is an E-Verify employer. For more information click on ourE-Verify Website . Working Title: FISCAL ASSISTANT I - 64003878 This is a highly responsible Fiscal Assistant I position in the Billing/ Fiscal Department at the Flagler County Health Department. Fiscal Assistant I, processes financial records which require independent decision making and judgment. Duties involve processing Medicaid HMO’s, Medicare and third party/commercial insurance claims. Responsible for reviewing insurance web portals for eligibility, deductibles, co-pays, co-insurances and payments. The position is responsible for a cash draw to receive payments form clients and must balance receipts daily. This position maintains a variety of complex accounting and financial records in Accounts Receivable reporting. This position also determines eligibility for a variety of State and Federal programs. The position reports directly to Operations Management Consultant 1. Audits, analyzes and reviews encounters and verifies all insurance information; makes the necessary determination as to the correct insurance, and processes all claims accordingly. Researches claims for Medicaid, Medicaid HMO’s, Medicare and other third-party insurance. Contacts insurance carriers when necessary to re-evaluate claims for payment. Processes payments and works denials according the Accounts Receivable Policy timelines. Responsible for collaborating with other departments, if necessary. Reviews claims for ICD-10 codes for accuracy. Runs appropriate HMS system reports to monitor and evaluate the Medical billing process for Medicaid, Medicaid Managed Health care Plans (MMA’s), and Medicare and third- party accounts receivables. Create and Maintain Denied Claims reports on all MMA plans. Develop training documents (cheat sheets) and on-going training on proper coding and billing which includes understanding modifier, CPT codes and ICD-10 for billing staff. Files complaints to The Agency for Health Care Administration, due to billing issues with MMA Plans. Reviews medical record to make sure appropriate CPT and diagnosis codes are utilized prior to sending bill file. Creates and maintains CAQH files on all Flagler County Health Department providers. Performs duties assisting Fiscal Assistant I (FA1). Runs appropriate HMS system reports including the Unbilled report. Generates Bill File Creation, which produces the Medicaid Billing File in the absence of other staff. Determines client’s eligibility for a variety of State and Federal programs. Verifies and updates client’s demographics as needed. Inputs charges and payments for private paying client services in CHD HMS system. Access to Social Security Data, Clinical information for services provided. Additional duties as requested by supervisor Required Knowledge, Skills, and Abilities: Ability to multi-task-Problem solve and use independent judgement Ability to correspond in writing and explain details to clients Ability to conduct in-depth interviews for program eligibility Qualifications: Must be willing to accept this salary if offered the position Must be willing to physically come in the office to perform the duties & responsibilities of the positions Must have current authorization to work in the United States without employer sponsorship Must have at least 1 years of dental or medical billing experience Preferred: Looking for a candidate that has extensive knowledge of insurance web-portals, ability to understand clients coverage, process claims and work denials. Florida Department of Health Mission, Vision, and Values: Mission: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. Vision: To be theHealthiestState in the Nation. Values: I nnovation: We search for creative solutions and manage resources wisely. C ollaboration: We use teamwork to achieve common goals & solve problems. A ccountability: We perform with integrity & respect. R esponsiveness: We achieve our mission by serving our customers & engaging our partners. E xcellence: We promote quality outcomes through learning & continuous performance improvement. Where You Will Work: The Benefits of Working for the State of Florida: Annual and Sick Leave benefits; Nine paid holidays and one Personal Holiday each year; State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options; Retirement plan options, including employer contributions Your responses to qualifying questions for this position must be verifiable by documentation provided through the electronic application process. This position requires a security background check and/or drug screening and participation in direct deposit. Any misrepresentations or omissions will disqualify you from employment consideration. Note: You will be required to provide your Social Security Number (SSN) in order to conduct this background check Successful completion of a drug test is a condition of employment for safety-sensitive positions. Male applicants born on or after October 1, 1962, will not be eligible for hire or promotion unless they are registered with the Selective Services System (SSS) before their 26th birthday, or have a Letter of Registration Exemption from the SSS. For more information, please visit the SSS website: If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. Your current retirement benefits may be cancelled, suspended or deemed ineligible depending upon the date of your retirement. The successful candidate will be required to complete the Form I-9 and that information will be verified using the E-Verify system. E-Verify is operated by the Department of Homeland Security in partnership with the Social Security Administration to verify employment eligibility. Incumbents may be required to perform emergency duty before, during, and/or beyond normal work hours or days. All Florida Department of Health positions require the incumbent to be able to learn and communicate effectively, orally and in writing, in English. Applicants who do not meet this requirement will not be considered. The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer and does not tolerate discrimination or violence in the workplace. Applicants requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center View phone number on click.appcast.io). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation. The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act. Florida has the third largest population of veterans in the nation with more than 1.5 million service men and women. The Florida Department of Health (department) is committed to serving members of the United States Armed Forces, veterans and their families by encouraging them to apply for vacancies that fit their area of knowledge and/or expertise. Through the Department's VALOR program, which expedites licensing for military veterans, the Department also waives initial licensing and application fees for military veterans who apply for a health care professional license within 60 months of an honorable discharge. These initiatives help ensure that the transition from military service into the workforce is as smooth as possible and reflects our appreciation for the dedication devoted to protecting our country. Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center View phone number on click.appcast.io). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation. The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act. VETERANS’ PREFERENCE. Pursuant to Chapter 295, Florida Statutes,candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements.Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans’ Preference documentation requirements are available by clicking here . All documentation is due by the close of the vacancy announcement. For assistance, call the People First Service Center at View phone number on click.appcast.io Monday - Friday, 8:00 a.m. to 6:00 p.m., Eastern time. Pursuant to Florida Law, 110.211 F. S., the State of Florida is an EEO employer. #J-18808-Ljbffr