What are the responsibilities and job description for the Billing Specialist position at Juneau County, WI?
Description
POSITION SUMMARY
This position provides advanced fiscal support by submitting medical claims to insurance companies and other source payers; and provides responsive, courteous, and efficient customer service in support of departmental operations.
Examples of Duties
ESSENTIAL FUNCTIONS
The following duties are normal for this position. However, they are not to be construed as exclusive or all–inclusive. To perform this job successfully, an individual must be able to perform each duty satisfactorily. Other duties may also be required or assigned.
- Provides customer service to internal and external customers; greets, receives and screens visitors and customers; addresses and resolves customer questions as able and refers complex inquiries, requests, or complaints to appropriate staff.
- Maintains computerized Accounts Receivable accounts for DHS including: collecting and compiling data, posting/reconciling charges and payments on accounts.
- Financial interview with consumer or guardian to verify patient or consumer eligibility and benefit coverage, including, but not limited to all referrals for services, admission, therapy, and any change in payer. If no insurance, determines client’s ability to pay in accordance with Wis State Statutes and obtains necessary information to verify.
- Enters insurance claim information for claims submittal. Prepares, reviews and submits claims, using software, in addition to any manual intervention necessary to timely claim submission for services rendered. Reviews for errors, corrects and resubmits claims.
- Communicates with insurance companies on unpaid or rejected claims and rebilling.
- Communicates with insurance companies on developing Letters of Agreements as well as prior authorization agreements.
- Fulfills credentialing requirements of behavioral health providers.
- Maintains and uploads PPS data to the State of WI portal.
- Compiles and inputs information to generate personal statements, including payments received, insurance status and amount due.
- Monitors claims for timely processing and correct documentation of payments.
- Inputs miscellaneous departmental charges for services.
- Completes accurate reconciliation of accounts.
- Prepares and submits all payer claims, including but not limited to insurance, Medicare, Medicaid, etc.
- Prepares and files appeals as necessary in the billing cycle.
16. Continually updates billing software to reflect the most current data.
17. Serves as a resource to patients/ consumers/families for billing and insurance questions.
18. Composes routine correspondence; proofreads and edits documents; enters, scans, updates, and maintains information in spreadsheets, databases, and reports.
19. Maintains electronic and paper filing and record systems to provide easy access to records and information; provides retention of records as required by Department and County policies.
20. Provides backup assistance to other department personnel as needed.
21. Participates in process improvement measures
22. Other duties as assigned.
EXPECTATIONS
- Interprets and applies Federal, State, municipal, and Department rules, regulations, and policies.
- Attends work regularly and is punctual.
- Behaves professionally and presents an appropriate standard of grooming, hygiene, and dress that align with health and safety standards.
- Conducts self in such a way as to reflect positively on the County.
- Fosters positive working relationships and accepts new responsibilities.
- Learns and understands the safe practices for the job being performed and complies with the safe work practices and personal protective requirements for the job.
Typical Qualifications
MINIMUM REQUIRED QUALIFICATIONS
- Associate’s degree from an accredited college in an accounting or related program and two (2) years’ work experience in medical insurance billing and coding.
- Must successfully pass caregiver and criminal background check.
Supplemental Information
REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES
- Knowledge of CPT codes, medical billing codes, and insurance billing processes.
- Knowledge of accounting procedures, and financial practices.
- Ability to understand and follow oral and written instructions and adhere to prescribed departmental routines.
- Ability to establish and maintain accurate records of assigned activities and operations.
- Skill in time management; prioritizing duties to accomplish a high volume of quality work product requiring minimal supervision.
- Ability to define problems, exercise sound judgment, and address a variety of situations successfully.
- Knowledge and ability to follow the policies and practices contained in the County Personnel Handbook.
- Ability to maintain confidentiality of all patient care information and assure patient rights and privacy are protected at all times per HIPAA.
- Ability to work the allocated hours of the position.
PHYSICAL AND WORK ENVIRONMENT
The physical and work environment characteristics described in this description are representative of those an employee encounters while performing the essential functions of this job.? Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as otherwise required by law. ?Employees needing reasonable accommodation should discuss the request with Human Resources.?
- This work requires the occasional exertion of up to 25 pounds of force; work regularly requires sitting, frequently requires standing, speaking or hearing, using hands to finger, handle or feel and repetitive motions and occasionally requires walking, stooping, kneeling, crouching or crawling and reaching with hands and arms.
- Work has standard vision requirements.
- Vocal communication is required for expressing or exchanging ideas by means of the spoken word.
- Hearing is required to perceive information at normal spoken word levels.
- Work requires preparing and analyzing written or computer data and observing general surroundings and activities.
- Work is generally in a moderately noisy office setting.?
Juneau County is an Equal Opportunity Employer.