Definition:

Under general supervision, perforrns billing and collection duties in the Billing Department for Medicaid members. Performs related duties as assigned.

Tasks:

Enters, reviews, and updates all cycle billing, codes, and account information; proofs and balances reports; estimates and makes manual adjustments to accounts as needed; prints bills to collect revenues; processes account service orders; audit of account accuracy; processes closing accounts for final payment.

Processes authorizations; balances daily revenues and payments, balance revenue and invoices to accounting reports; prepares spread sheet for daily and monthly balancing of revenues. Prepares invoices. Updates master transaction journals account. Report weekly, monthly and yearly.

Processes delinquent accounts for collection; prepares notices for delivery to clients; monitors reports for client accounts, applies late fees, adjustment reversals, processes web payments, processes EFTs and EBUs, processes client transaction files and post, processes bad debt write offs, payment redistribution, over-short adjustment process, transfer of overpayments, correspondence, etc.; reviews requests and approves/denies extensions/extended payment plans; collection of outstanding debt; provides training and guidance to office personnel; provides assistance to customer service representatives regarding complex billing collection and account adjustments; provides customer service as needed.

Knowledge, Skills, and Other Characteristics:

• Knowledge of applicable federal, state, and local laws, statutes, ordinances, regulations, rules, policies, and procedures.
• Knowledge of the policies and procedures applicable to medical billing and collection services,
• Knowledge ofthe basic principles of automated medical systems.
• Knowledge of customer service techniques.
• Skill in basic mathematical calculations (addition, subtraction, multiplication, division).
• Effective interpersonal relations.
• Skill in the operation of standard office equipment, computer hardware and software.
• Analytical and pays attention to details
• Skilt in dealing effectively with the public.

Physical Requirements:

Primarily sedentary work with the occasional need to move around the office and lift/carry up to 20 pounds. Requires occasional standing for periods of time plus visual inspection of documents in file folders and system. Requires extensive use of computers, voice, and electronic communications systems.

Qualifications:

Requires College diploma or higher and three (3) years of experience in medical billing and collection, or in customer service work. Knowledge of the Senior Customer Service Representative position preferred. Employees are required to pass the HHA exchange and Account Edge training courses identified for their position and listed in the most recent version of the HHA Exchange Training Guide; within one (1) year of placement into this position.