Description

BASIC FUNCTION: Supports outsourced billing provider with billing and coding practices under the supervision of the Chief Financial Officer and LeafBridge Services Director, some of which are confidential in nature. Maintain and update the Electronic Medical Records (EMR) system including adding new clients, staff and scheduling.

RESPONSIBILITIES:

1. Reviews services delivered as documented in EMR system to prepare ledger for billing.

2. Originate/enter new case demographics for therapy programs (children and adults); assigning case numbers to all new clients, etc.

3. Send and follow up with all PT/OT/ST treatment plans to physicians of children with Medicaid/private insurance coverage.

4. Complete all invoices for LeafBridge Service including school contracts, extended school year services, LB Alternative Education Program, evaluations and scholarship agreements.

5. Support therapy services with scheduling new and existing client throughout the calendar year on an ongoing basis. May need to complete seasonal scheduling 4 times a year.

6. Supply outside providers with medical record information as approved by Manager of Children & Family Services (SSI, Legal).

7. Provide technical support to therapy staff regarding clinical documentation and billing issues.

8. Work as a liaison between EMR representatives and outsourced billing provider and provide technical support within the EMR system.

9. Daily audit of client ledgers to assure accurate billing by therapists.

10. Monitor current charge table and develop appropriate billing codes.

11. Review client statements/sliding fee computations on a monthly basis as indicated.

12. Initiates processes for financial components of intake, including but not limited to: verification of insurance prior to evaluation and re-verification of insurance on annual basis or as indicated. Participate in all intake meeting.

13. Assist families in maximizing benefit structure by facilitating additional service request with participating insurance company. Ask for additional units of service.

14. Explore potential new contracts/payor sources to further develop UCP’s network of care.

15. Promptly follow-up on all claims to assure timely response to acquire additional service and units of service.

16. Support outsourced billing provider in responding to insurance and other payors regarding requests for more information, clinical documentation, claims rejections, etc.

17. Send all remittances and cash logs via e-mail or secure portal to outsourced billing provider daily.

18. Assures that all insurance information, primary, secondary and tertiary coverage are in the system to promptly bill out services.

19. Assure that all diagnoses and prescriptions are properly placed in system prior to billing.

20. Support outsourced billing provider with information to build a tracking mechanism to monitor all billing denials to minimize financial loss to UCP and impact on family.

21. Assists in reviewing accounts receivable aging with the Children’s & Family Services Manager at least monthly to identify collection issues and develops with the Director of LeafBridge Services and Chief Financial Officer a course of action to address slow and unpaid accounts.

22. Assist with other duties as assigned specifically in the financial department. Cross train to support other programs.

s requested.

Qualifications

QUALIFICATIONS: High school diploma. Associate degree preferred. CPT coding specialist preferred. Two (2) to three (3) years medical billing experience in a health services or social services agency. Proficiency with Microsoft products including Word, Excel, Access, Outlook, etc. Experience with Raintree medical billing software preferred. Must have reliable transportation and a valid Ohio driver’s license with three (3) or less moving violations