COMPLIANCE TECH II

This position assists the supervisor in creating consumer chart and billing files, completing registration forms, ROI’s, billing duties, and other correspondence. May help create reports.

• Maintain, verify, enter, and update consumer registration data, alternate resources, and Releases of Information (ROI) to ensure all files are legally authenticated before entry into the Electronic Health Record (EHR).


• Perform all data tasks for demographics, charges, payments, and adjustment transactions in a timely manner. Process self-pay payments and provide backup for entering Remittance Advices (RAs) into the EHR.


• Compiles and computes data according to statistical formulas for use in statistical reporting. May perform computations and compile charts and graphs for use by supervisor and Internal Evaluator. 


• Screen and apply admitting consumers for SNAP and Medicaid benefits, regardless of income status or existing payers, to ensure maximum resource utilization.


• Assists in training new Compliance Technicians, providing mentorship as required.


• Obtain and forward supporting documentation for third-party payers. Monitor aging accounts and re-bill third-party payers after 60 days of non-response.


• Reconcile system totals against daily batch audits. Investigate discrepancies and correct errors using appropriate mechanisms prior to posting to consumer accounts.


• Perform overall control procedures for daily balancing, monthly closing, and year-end closures for all receivables using standard control forms.


• Maintain detailed records of SNAP benefits and transactions for consumers qualifying through the Division of Public Assistance (DPA).


• Process self-pay payments provided by consumers with previous service charges.


• Promotes courteous communication to obtain necessary admission information from consumers and families while promoting a positive public image.


• Assist the Compliance Supervisor with the completion and follow-through of Qualified Addiction Professional (QAPs) to meet CARF and agency standards.


• Collect, review, and enter data daily; maintain precise records of billing notes, billing correspondence, and payments to ensure "audit-proof" records.


• Function as a primary safeguard for consumer confidentiality, ensuring all data collection and storage processes strictly adhere to HIPAA and 42 CFR Part 2 regulations.


• Serve as a backup for other clerical and data staff; maintain flexibility to fill in for team members with little to no notice.


• Perform other job-related duties as assigned.

NECESSARY KNOWLEDGE, SKILLS, AND ABILITY

• Excellent knowledge and daily application of HIPAA and 42 CFR Part 2 regulations to maintain a secure and compliant environment.


• Ability to ensure all consumer data, Releases of Information (ROI), and records are legally authenticated and stored according to federal and state guidelines.


• Knowledge of billing procedures and the ability to interpret complex assignments to ensure financial and clinical data meets internal and external audit standards.


• Above-average proficiency in Windows, Microsoft Word, and Excel, with a specific ability to accurately input and manage information within consumer portals and Electronic Health Records (EHR).


• Skill in tracking data, running reports, and maintaining organized, legible records for use in monthly, quarterly, and annual agency reporting.


• Ability to follow complex written and verbal instructions to compile data for use by supervisors and internal evaluators.


• Demonstrated experience and success working effectively with Alaska Native and Native American populations, with a deep sensitivity to diverse cultures and lifestyles.


• Knowledge of specialized techniques to assist and support potentially escalated individuals during the sensitive data collection or intake process.


• Exceptional interpersonal skills used to establish and maintain cooperative, professional relationships with colleagues, supervisors, and external agencies.


• Proven ability to report to work in a timely manner and maintain strict adherence to assignment, training, and communication deadlines.


• Skilled in managing multiple, often conflicting, priorities concurrently while meeting all designated project deadlines.


• Demonstrated ability to work effectively as an independent contributor while remaining a productive and reliable member of a multidisciplinary team.

• High school diploma or equivalent, and


• Minimum of three (3) years of experience involving data entry, billing, and/or performing diverse administrative duties.


• Two (2) years of experience working in a service-oriented environment.


• A combination of experience, education, and training that provides the required knowledge, skills, and abilities may substitute for degree requirements.

• Associate’s degree in business administration or related field.


• Four (4) years of experience involving data management.