Billing Clerk

Aspire Behavioral Health & Developmental Disabilities Services Job Description

A. ORGANIZATIONAL RELATIONSHIPS

Position Title: Billing Clerk 1-FIS011

Position Number:

Date:

Employee:

Work Unit: AACSB Administration County: Dougherty

Immediate Supervisor's Title: Billing Manager and Revenue Cycle ManagementDirector

List positions supervised through immediate contact: None

B. QUALIFICATIONS:

Knowledge of basic accounting, data entry, balancing accounts, ability to followprocessing guidelines according to agency procedures, ability to use appropriatesoftware (e.g., MS Office, EMR), ability to handle money and checks, skills inbasic math, ability to address patients/customers in a courteous andprofessional manner, knowledge of billing policies and procedures. High schooldiploma. One or more years of experience in working insurance and denials foreffective resolution. Experience working with Electronic Medical Records. Twoor more years in medical billing and collections. Functional knowledge ofcomputer and Microsoft Office. Must work well in a team environment andindependently.

Preference for: one or more years in State Contract Service Environment.

Preference for: one or more years working with Developmental Disability billing.

(Physical) No lifting of more than 20 pounds.

C. EQUIPMENT THAT REQUIRES SAFE AND EFFECTIVE USE:

(Include emergency equipment, treatment equipment and high risk equipment)

D. BL00DBORNE PATHOGEN CATEGORY (check one)

____Employee routinely performs tasks that involve exposure to blood or otherpotentially infectious material as part of their assigned duties (Category I).

____Employee performs assigned tasks which does not involve exposure to blood orother potentially infectious matter, BUT employment may require performingunplanned category I tasks

(Category II).

X Employee performs assigned tasks which involve no exposure to blood orother potentially infectious material AND performance of category I tasks arenot a condition of employment

(Category Ill).

E. MANDATORY TRAINING CATEGORY (Check One)

_X__ Administrative

_____

____ Direct Care

___

____ Medical

F. PERFORMANCE IMPROVEMENT

The Albany Area Community Service Board goal is to continually improve thedelivery of service by improvement of consumer outcomes and satisfaction. Allemployees have a role in performance improvement and are expected to interactcollaboratively with co-workers, and other contacts to provide consistent,high-quality, consumer focused services.

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Position Title: Billing Clerk 1-FIS011

Position Number:

G. ASSIGNED DUTIES

Duties may include, but are not limited to:

Entering and process claim data:Provides on-going/on-call operational and end-user assistance:Analyzes and resolved problems on a local level in an accurate andtimely manner.Post and track payments.Communicate with providers with progress in resolving billing issues.Generate and send client statements monthly.Enter financial or billing formation in clients accounts.Work monthly aging reports for outstanding balances and resubmitcorrected claims.Resolve insurance authorizations and denials.Submit appeals to insurance companies as needed to secure payments onclaims.Serve as point of contact for clients that have questions regardingtheir statements or account.Answers calls from local administrators and/or users in a timely,efficient, and professional mannerDocument problems and resolutions within agency support systemListens to end-users and maintain a professional business relationship

Entering and process all billing data for Developmental DisabilityParticipants (if assigned):Calculates data and completes monthly reports of DD services for CEO andState required reports.Tracks Authorizations and notifies by email appropriate staff when anyconsumers authorizations are going to expire (30 days ahead of expiration) andif units are depleted and new authorizations are needed.Works with managers and supervisors to assist with all billing andauthorization problems and reaches a resolution in a timely mannerShares responsibility of downloading and filing assigned insurance each weekand not later than Friday of each week and posting of payments.Communicates with insurance providers to reach resolutions for billingissues and reports to appropriate staff and CIMO of all issues that will cause aclaim rejection, billing, coding and use of modifier issues and errors.Works insurance denials to reach resolution within 5 days from the date theRA is received. Alerts appropriate staff of needed changes or corrections andfollows through to ensure claim is resubmitted within in the time limits foreach insurance provider.Work with DD managers and supervisors to assist with all billing andauthorization problems and reaches a resolution in a timely manner. Notifyimmediate supervisor if problems are not resolved within 5 daysEntering and process all billing data for non-DD claims (if assigned):Extract, enter, works insurance denials to reach resolution within 5days from the date the RA is received. Alerts appropriate staff of neededchanges or corrections, and follows through to ensure claims is resubmittedwithin the time limits for each insurance provider.Work with managers and supervisors to assist with all billing andauthorization problems, and reaches a resolution in a timely manner. Notifyimmediate supervisor if problems are not resolved within 5 days.

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Medical Records Support:Provide support to the Medical Records Department by releasing medicalinformation in either oral or written format. Obtaining necessary releasesfrom Individuals, following HIPAA regulations, to allow for the release of suchmedical information.

DUTIES INCLUDE:

Performs billing functions, completes required accounting documentation, such asbatch reports, bank statements, and agency generated reports and/or relatedrecords. Enters financial transactions into accounting systems or files.Verifies and corrects accounting and financial information in area ofassignment. Compiles data, prepares and distributes billing/claim requests, bankdeposits, or related reports. Copies, distributes, receives and/or mailsletters, bills, memos, statements of account, and other documents and materials.Maintains files and records. May make routine determinations of client abilityto pay, review documents to compute fees or charges due, accept payments fromcustomers, and/or apply payments to existing accounts. Completes and mailsbills, invoices, and other financial documents. May review documents such aspurchase orders, invoices, or hospital records in order to compute fees andcharges due. Operates computers programmed with accounting software to record,store, and analyze information. Review files, records, and other documents toobtain information to respond to requests.

NOTE: This position will answer directly to the

Position Title: Billing Manager and Revenue Cycle Management Director