Position Summary:

Person in this position will oversee the accounts receivable billing functions by managing client accounts, creating billing, and documenting collections while ensuring accuracy according to regulatory standards and in compliance with Illinois Medicaid, Illinois Department of Human Services (IDHS) Substance Use and Prevention (SUPR), and insurance contracts. Understanding and implementing applicable billing requirements that can differ across payers on a contract-by-contract basis is a must.

Essential Job Functions:

• Supervise billing team staff members.
• Create billing claims, including medical coding, claims submissions to grantors (including IDHS SUPR online claims coding and posting), payment posting, accounts receivable follow-up, accounts payable management, and reimbursement management.
• Produce billing invoices monthly.
• Prepare billing and claims accurately. Follow-up on issues found in clinical service documentation with clinical staff managers.
• Ensure completion is performed timely, effectively, and efficiently within timely filing limits for each payer. Review the documented reasons for denials that cannot be re-billed and communicate this to the regional vice president.
• Submit Check requests and reimbursements to accounting for staff reimbursements.
• Reconciliations for Bank Statement and Credit Card Statement monthly.
• Assist in the development and oversee annual budgets.
• Assist in the development and oversee program budgets for current and proposed contracts and grants.
• Coordinate the overall functions of the department to ensure maximization of cash flow.
• Monitor performance and ensure quality assurance standards are met.
• Produce quarterly and annual reports for grants, agreements, and contracts.
• Provide regular feedback to billing staff and clinical management.
• Meets grant compliance requirements for individual grant budgets, re-budgeting requests, accounting procedures, reporting procedures, file retention, and other government regulations.
• Manages accounts receivable, including preparing accurate contract billings and submitting them to appropriate agencies for payment. Pursues collection of accounts receivable as required.
• Review accounts payable to ensure invoices are legitimate and have proper approvals and prepares and enters invoices as needed.

• Reviews and maintains a detailed general ledger for accuracy, allowability, and appropriateness of transactions.
• Reconciles Monthly Bank Card and EBT Reports.
• Maintains detailed grant files containing contracts, correspondence, receipts, expense statements, billing statements, and grant payments.
• Participates in regular meetings with Regional Accountant and grant directors to review expenses and ensure that budgets are being spent appropriately.
• Proofs transactions for accuracy, allowability, and appropriateness to cost centers, sub-cost centers, and GL accounts.
• Coordinate annual Medicaid training certification for all staff. Submit completed Medicaid training certificates and WestCare Illinois provider information to each Medicaid payer annually and when updated.
• Embrace and embody the mission, vision, guiding principles, clinical vision, and goals of WestCare Foundation.
• Perform any other duties as assigned.

Certifications/Licenses:

• Obtain annual Medicaid training certification.

Education:

• Associate or bachelor’s degree in health administration, business administration, or related field is preferred. High school diploma or equivalent is required.

Experience and Competencies:

• Two-plus years of billing experience (grant and insurance preferred)
• Knowledge of medical terminology, CPT, ICD-10, and HCPCS codes
• Superior writing skills with strong documentation
• Bilingual is preferred
• Must be highly organized, detail focused, and have excellent time management
• Must possess extremely strong computer skills, including advanced Microsoft Excel
• Excellent communication and interpersonal skills, both in person and over the phone
• Ability to pass background check
• Ability to obtain and maintain DCFS CANTS clearance
• Ability to obtain and maintain OIG LEIE clearance
• Ability to pass pre-employment drug screening
• Ability to exercise good judgment and discretion
• Ability to work well in a team environment
• Ability to work under minimum supervision
• Adherence to the highest standard of ethical conduct, especially to standards governing confidentiality
• Must have professional appearance and demeanor
• Must be culturally/linguistically sensitive to populations served
• Ability to obtain and maintain CPR certification, first aid certification, and annual tuberculosis test

Working Conditions:

• Work is primarily performed in a professional setting.
• There may be periodic travel: local and regional.

Essential Physical and Mental Demands of the Job

The employee must be able to perform the following essential duties and activities with or without accommodation:

Physical Demands:

• Requires mobility and physical activity: Having an adequate range of body motion and mobility to work in an office, residential, or outdoor environment including standing and walking (even and uneven surfaces), sitting for extended periods of time, bending, twisting, reaching, balancing, occasional lifting and carrying of up to 50 pounds. Use of computer and telephone systems is required, which includes coordination of eye and hand, and fine manipulation by the hands (typing, writing, and working with files).

Requires the ability to defend oneself and clients in physically abusive situations through the use of approved verbal de-escalation techniques.

• Requires talking: Expressing or exchanging ideas by means of the spoken word. Talking is required to impart oral information to employees, clients, patients, and the public, and in those activities in which the employee is required to convey detailed or important spoken instructions to others accurately, loudly, or quickly.
• Requires hearing: Hearing is required to receive and communicate detailed information through oral communication.
• Requires seeing: Clarity of vision at 20 inches or less and at distance. This factor is required to complete paperwork for many of the employee’s essential job functions and to observe client behavior and activities in and out of the facility.

• The normal work routine involves no exposure to human blood, body fluids or tissues. However, exposure or potential exposure may be required as a condition of employment. Appropriate personal protective equipment will be readily available to every employee.

Mental Demands:

• Requires the ability to collect and analyze complex numerical and written data and verbal information to reach logical conclusions.
• Requires the ability to work and cooperate with clients, co-workers, managers, the public and employees at all levels in order to exchange ideas, information, instructions and opinions.
• Requires the ability to work under stress and in emotionally charged settings.
• The ability to defend oneself and clients in mentally/verbally abusive situations through the use of approved mental/verbal de-escalation techniques.