Performs medical billing and adjudication work for the Health Department.
Example of Duties
(Any one position does not include all of the duties listed; nor do the listed examples include all duties which may be found in positions of this class). Receives and reconciles payments from insurance companies, private agencies, Medicaid, Medicare, voucher and individuals against billing reports. Communicates with Medicare, Medicaid, and Insurance representatives to ensure billing processes are functioning correctly.
Compiles and reviews invoices and monthly billing statements; monitors Medicare, Medicaid, and insurance billing error reports to ensure accuracy and to identify system flaws. Conducts research to correct payment denials or errors and prepares denied claims for re-billing as appropriate.
Receives and responds to client billing inquiries. Identifies billing errors; makes corrections and/or ensures errors are corrected by appropriate Health Department staff; provides assistance to staff as requested. Performs follow up on past due accounts; makes billing and payment arrangements with clients and companies; identifies past due accounts and prepares files to turn over to collection agency. Balances cash on hand against receipts; prepares and balances deposits; runs tapes on checks and cash; posts receipts as appropriate. Updates account, vendor, and client records as necessary.
Establishes and maintains various files and record systems; distributes and organizes incoming and outgoing correspondence and files. Tracks purchase price for all shots and determines maximum allowable annual fees for billing. Generates monthly, quarterly, and/or annual reports for management review and submission to county, state and federal agencies as required by various statutes, regulations or funding requirements. Serves as liaison with Medicare, Medicaid, and insurance representatives to insure billing processes are working correctly; furnishes providers with updated fee schedules. Reviews and submits contracts with insurance companies, Medicaid and Medicare according to County policy.
Performs a variety of complex clerical and accounting functions including preparing, typing, and compiling reports and billings, establishing filing systems and various receipt and expenditure ledgers; open and sort mail. Operates a motor vehicle in a safe manner and in compliance with all Utah laws and regulations. Performs related duties as assigned.
Education and Experience
Graduation from high school (or equivalent), plus four (4) years of full-time progressively responsible accounting related experience (i.e., billing, account reconciliation, accounts payable/receivable, etc.). An acceptable combination of education and experience may be considered.
Preference given for related experience in medical billing or coding and college coursework in accounting. Preference for work experience in the Davis County Health Department.
Furnish personal transportation for on-the-job travel; employees driving a personal or a County vehicle for job related travel must possess a valid driver license and must operate a motor vehicle in a safe manner; new employees with an out-of-state license must obtain a valid Utah Driver License within sixty (60) days of hire date (exceptions for military personnel and their dependents). Employees driving a personal vehicle while on county business must maintain the minimum vehicle liability insurance as specified in the Utah Code.
Knowledge, Skills, and Abilities
Considerable knowledge of: County financial policies, procedures, and practices; Medicare/Medicaid services, insurance regulations, standards and laws related to medical billing, and contract terminology; accounting and bookkeeping practices and procedures; applicable software applications; standard computerized office practices and procedures. Working knowledge of: CPT and diagnosis codes. Skill in: basic bookkeeping; data entry, word processing and creating/maintaining spreadsheets; typing 40 wpm (net) as required by the position; using a standard calculator; using all applicable computer hardware and software including Microsoft Excel and Word. This position may require the driving of a motor vehicle; skill in operating a motor vehicle in a safe manner and in compliance with applicable Utah laws and regulations; ability to insure motor vehicle is operating in a safe manner; knowledge of Utah motor vehicle rules and regulations. Ability to: perform math computations rapidly and accurately; respond to billing questions and concerns; work on multiple tasks simultaneously with frequent interruptions; work with detail and maintain a high degree of accuracy; create and maintain documents and spreadsheets; properly handle sensitive information/records and maintain strict confidentiality; respond to angry patrons with diplomacy; train others in medical coding/billing; work for sustained periods maintaining concentrated attention to detail; follow written and oral instructions; communicate effectively (orally and in writing); establish and maintain effective working relationships with supervisors, co-workers, other agencies and the general public.
Davis County is a drug-free workplace. All successful applicants for positions in the County must successfully pass a drug screen prior to employment.