Billing Specialist

Division: Accounting

Reports to: Billing Manager

Worksite: Facility Center

License/Certification Requirements: Must have a valid MN driver's license, current insurance or be insurable preferred.

Summary: Administer CW-TCM, billing. Monitor all billing policies and develop procedures for efficient billing protocols, maintain DAANES, MMIS and MINITS.

Education Requirements and Experience:

Associate of Science Degree in; Medical Billing and Coding.

A minimum of a High School Diploma or General Education Diploma, plus any combination of training, education and practical experience equivalent to a two-year degree, including supporting documentation would be considered along with extensive computer and billing experience.

Additional Qualifications and Skills:

Knowledge of CCDTF authorized services billing rates, updates and compliance.

Familiarity with: LLBO Reservation, Social Service Agencies, CD Programs and MN Dept. of Human Services CD.

Excellent computer literacy, data entry and professional word processing skills.

Excellent; organizational, public relations and communication skills.

Good oral and written communication skills and customer service skills.

Ability to work independently and establish work priorities.

Maintain a high degree of confidentiality and professional ethics.

If chemically dependent must document one year of chemical free sobriety.

Native American preference.

Pre-employment and employment drug testing is mandatory for all Leech Lake Band of Ojibwe positions.

Supervisory Duties:

None

Duties/Responsibilities:

Assist and train new staff in centralized billing.

Compliance responsibilities are to ensure that Client Placement Authorizations (CPA) are documented in charts that will, include required treatment formats completed by the provider, (counselor, assessors and others) that provide treatment activities.

Compliance will follow-up and follow through on authorizations for needed review and updates for all placements and will make the necessary changes for client treatment funding status, as required on a 30-day time frames or updates.

Compliance for CPA will include proper billing codes and identifying proper resources for payment and correct service fees.

General compliance activities will ensure that treatment authorizations for billing are not subject for unpaid claims that will add liability to LLBO for payment, as stated in the authorization contract.

Design a process for local providers to be compliant with billing documentations.

Follow data privacy guidelines and safeguards for reimbursement claims and client records.

Receive client billing slips from case managers, CD counselors and other professionals for data collection needed to

transmit billing for reimbursement to the state for authorized professional services.

Verify insurance (including Third Party Liability, prepaid or private insurance) of all clients receiving professional services is correct and in compliance with HIPPA using MN-ITS or EVS.

Bill private payment source prior to billing DHS.

Contact various State agencies to verify clients' current eligibility and make corrections as needed.

Verify all client placement authorizations and service agreements are correct for billing.

Ensure all DAANES is entered in a timely and correct manner for reimbursement.

Keep records of all billing forms submitted for reimbursements and monitor all payments received.

Prepare reports for the Human Service Director, A&D Programs Director and Child Welfare Director to aid in analysis of revenue generated.

Must comply with Code of Ethics of the A&D Programs and LLBO.

Attend and or conduct all mandatory meetings and trainings as required.

Maintain confidentiality and professional ethics at all times.

Travel in and out of the state on a possibly regular basis.

Understanding and sensitivity to Native American culture.

Adhere to policies governing staff conduct.

All other related duties as assigned.

Physical Requirements:

Sedentary work.

Subject to internal working conditions.

Non-smoking environment.