DEPARTMENT: Business Services
OPENING DATE: May 23, 2018
CLOSING DATE: Until Filled
JOB PURPOSE: The Billing, Collections and Insurance Assistant is responsible for providing administrative and clerical services in order to ensure effective and efficient operations within our billing department.
EXAMPLES OF ESSENTIAL RESPONSIBILITIES AND DUTIES:
- Use a personal computer and a variety of office software applications including word processing, email, and file management. Prepare documents in Google Word/Documents from scratch or using predefined templates and form letters. Create or maintain files in Google Excel.
- Operate other office equipment such as printers, copy machines, and fax machines. May serve as a liaison with service and vendor personnel.
- Assist in resolving problems and ensuring satisfactory customer service.
- Fax, scan, and copy documents.
- Notify front desk of needed office supplies.
- Verify insurance benefits for new and existing clients, document in billing system, Therapy Appointments (TA). Notify new clients prior to their first intake appointment if any collection is needed for deductible, copayment, or coinsurance.
- Create Over the Counter (OTC) Collections Log weekly by inserting appointment time, provider name, and insurance company.
- Add treatment plan dates and other information located in the alert tab to the OTC Log as necessary (ie, excuse notes, appeal letters).
- Generate client collections data and add notes on the daily OTC Log including insurance company copayments, coinsurance, deductibles, and/or outstanding balances due along with payment plan arrangements.
- Call clients with outstanding balances to try to collect via phone before sending them to collections.
- Create and maintain the collections spreadsheet and submit clients to Credit Bureau Data (CBD) with outstanding balances 120+ days.
- Post payments received from CBD.
- Maintain Employee Assistance Plan (EAP) spreadsheet.
- Verify EAP sessions and required paperwork with each EAP company.
- Prepare and distribute client EAP paperwork to outpatient providers for completion.
- Collect completed EAP paperwork and submit electronic or papers claims and paperwork meeting each EAP company requirement.
- Follow up with EAP claims that haven’t been paid in a timely manner.
- Post EAP payments in TherapyAppointment.
- Scan all client EAP paperwork into billing system, TA, at the completion of all EAP sessions.
- Attend and participate in the weekly Business Services meetings. Notify supervisor when unable to attend.
- Attend quarterly all employee meetings as scheduled. Assist with set-up and cleanup as needed. Notify supervisor when unable to attend.
- Understand and follow policies and procedures of the Billing Services department and of Stein Counseling and Consulting Services, Ltd., as outlined in the department and agency policy manuals.
- Participate in regularly scheduled supervision and ongoing evaluation.
- Develop personal and professional goals annually.
- Maintain acceptable ratings (75% or better) in all areas on performance reviews (job performance, supervisor ratings, etc).
- Perform other duties and responsibilities, consistent with this position description, as requested by the Clinic Administrator, Clinic Services Manager and/or President of Stein Counseling and Consulting Services, Ltd.
SECONDARY RESPONSIBILITIES AND DUTIES (Cross training with other Business Services Staff as necessary):
- Verify Medicaid insurance benefits daily using the Wisconsin Medicaid Forward Portal, print eligibility screens, document in TA and on the OTC log, and share with Front Desk Office Assistant.
- Complete Daily Reconciliation and Payment Batch Reports based on OTC collections log, daily credit card receipts, daily credit card report, and daily deposit(s). After report is reviewed by the Clinic Administrator, scan daily report to Google Drive.
- Review and submit outpatient claims daily in TherapyAppointment (TA) either electronically or via paper when necessary (eg, review claims for correct CPT code, place of service code, and amount collected).
- Post payment received by check, EFT, or cash in the correct billing system, TA or WorkFlowMax (WFM).
- Submit secondary claims for clients with both primary and secondary insurance.
- Print out electronic remittance advice (ERAs) from clearinghouse, OfficeAlly, or any other payer submitting remits via email.
- Match electronic fund transfer (EFT) deposits with ERAs received from multiple insurance and employee assistance program (EAP) companies.
- Run statements weekly and give to Billing Manager for review. Once statements have been reviewed, scan and mail them to clients.
- Create monthly spreadsheet for payment of Inclusa and Care Wisconsin in-home and outpatient client claims for travel, collateral contact, and paperwork.
- Track authorizations for clients (Medicaid, Tricare, etc) on appropriate spreadsheet and in TA.
- Provide provider with appropriate paperwork to obtain a new or update an old referral, and submit to insurance company for approval,
WORK ENVIRONMENT: General office environment. Work is generally sedentary in nature, but may require standing and walking part of the time. Work is generally performed within an office environment, with standard office equipment available.
KNOWLEDGE/SKILLS:
- Employ effective telephone and interpersonal communication skills
- Possess competency, proficiency, and accuracy with data entry and managing various computer software programs
- Demonstrate effective and efficient organizational and planning skills
- Possess spirit of teamwork, positive outlook
- Must be flexible, reliable, and adaptable to meet the needs of the agency
- Consistently make sound decisions and problem solve effectively
- Communicate professionally with clients, supervisors, peers, and persons outside organization
- Resolve conflicts and effectively employ negotiation skills with others
- Possess basic knowledge of computers (Word, email, internet, etc) as well as typical office equipment (fax, copier, scanning, etc).
- Possess the ability to work independently, including organizing, planning, and prioritizing work
- Maintain emotional control under stress
- Follow business confidentiality procedures
- Follow HIPAA guidelines, complete yearly training
EDUCATION AND EXPERIENCE: High School diploma required; preference given for candidates with billing and insurance experience in a health or human services setting and/or a college education. Computer experience with Mac helpful.
SUPERVISED BY: This position is supervised by the Billing Manager.
HOURS: Daytime Position: M, T, W, Th, F 8:00 a.m. to 5:00 p.m.