SUMMARY OF DUTIES:

Maintain and follow current Medicaid, Medicare and other insurance procedures and requirements.  Maintain and follow managed care insurance procedures and requirements with respect to number of allowed visits, etc.  Prepare client billings to maximize the timely receipt of income.  Supervise and train the Billing Clerk(s).

RESPONSIBILITIES:

·  Maintain and update billing procedure manual.

·  Organize, maintain and review managed care contracts and other private insurance carriers for revised billing procedures.

·  Edit and review all transactions on an exception basis to verify the visits are billed in accordance with current billing procedures, ensuring that all billings are submitted timely.

·  Maintain records of receivables and dates paid.

·  Produce computer reports of billing information, on an as needed basis, in a timely manner.

·  Review on a quarterly basis "old" unpaid billings to determine if new information will allow the billing to become collectable.

·  Supervise the Billing Clerk(s).

·  Maintain agency electronic database.

·  Be available to consult with program staff around billing issues.

·  Schedule and assigned duties are subject to change based on the needs of the program and the clients we serve.

REQUIRED KNOWLEDGE AND SKILLS:

·  Knowledge of medical billing procedures including the ability to understand and implement requirements of insurance payers.

·  Ability to communicate well and to establish and maintain good working relationships.

·  Ability to organize and supervise all billing functions, as well as solve problems.

·  Ability to work independently and to establish and meet deadlines.

·  Ability to assist in design of reports and revision of procedures.

QUALIFICATIONS:

·  Graduation from a four year or two year business school/community college with courses in computers and medical terminology and two years paid experience performing a medical billing function

OR

·  High school diploma plus eight years' experience performing a medical billing function, of which one year is in a supervisory capacity.

·  Requires knowledge of current computer operations, billing software and telecommunications systems.