POSITION SUMMARY

This position is responsible for the billing and collections process, ensuring services are accurately billed, and revenues are collected, by working with clients, staff, and our contracted external billing company.  Specifically, this position provides excellent customer service, addresses client, and claim follow-ups, denials and appeals, and the collection of outstanding and delinquent accounts.

POSITION ACCOUNTABILITY

DUTIES: 

• Handles verification of benefits for third party insurance clients, and effectively communicates with clients and staff. 
• Assist with the development of billing and collection, accounting and admissions policies and procedures where applicable. 
• Ensure adequate documentation is maintained and available to support the billing and collection process.
• Coordinates with admissions and ensures appropriate collection of payments.
• Identify, address, and resolve billing discrepancies.
• Arrange approved payment options and plans and rescue delinquent accounts receivable.
• Maintains relationship with external billing company and assists with denials and appeals process.
• Complete Medi-Cal eligibility and “adhoc” reporting.
• Reviews and monitors accounts receivable and makes recommendations to the CFO regarding non collectible accounts. 
• Cross train and provide backup support and assistance for the billing specialist and other accounting areas as needed. 
• Maintains confidentiality, ensures compliance with policies and procedures, and follows HIPAA regulations. Other duties as assigned.

COMPETENCIES

• Competent in required job skills and knowledge, exhibits ability to learn and apply new skills.  Keeps abreast of current developments, requires minimal supervision, displays understanding of how job relates to others and uses resources effectively. 
• Displays a willingness to make decision and exhibits sound and accurate judgment.  Supports and explains reasoning for decisions, includes appropriate people in decision making process and makes timely decision.
• Displays sound problem-solving skills. Identifies problems in a timely manner, gathers and analyzes information skillfully and develops alternative solutions.  Resolves problems in early stages and works well in group problem solving situations. 
• Adapts well to changes in the work environment, manages competing demands and accepts criticism and feedback.  Change’s approach or method to best fit the situation. 
• Communication: Competency to communicate and expresses ideas and thoughts both verbally and in writing. Good listening and comprehension skills, communicates adequately to keep others informed using appropriate communication methods. 
• Customer service: Displays courtesy and sensitivity.  Must be able to manage difficult or emotional client situation, respond to client needs and solicits customer feedback to improve service.
• Dependability: Respond to request for service and assistance, follow instructions and respond to management direction.  Takes responsibility for own actions and doing the best job possible.
• Use of technology: Demonstrates required skills, and adapts well to new technologies, troubleshoots technological problems, uses technology to increase productivity, and keeps technical skills up to date. Must have outstanding attention to detail skills, can multi-task, and affectively prioritize to meet deadlines.
• Must have sound judgment in making decisions and understanding the impact to themselves, clients, employees, and the Center.

ABILITIES

• Ability to maintain a friendly, courteous, professional demeanor and provide excellent customer service.
• Ability to work independently, or collaboratively in a team environment.
• Ability to interpret and analyze data and be able to draw valid conclusions or recommendations. Ability to interact effectively at various social levels and across diverse cultures.

QUALIFICIATIONS

MINIMUM QUALIFICATIONS

• 2 years’ experience as a billing and collections worker in a healthcare or a care facility type environment, preferably in a substance abuse facility.
• Working knowledge of collection techniques and practices, and billing and coding rules and regulations.
• Knowledge of debt collection laws and regulations.
• Strong customer services and communication skills, and the ability to diffuse and deescalate situations.
• Knowledge of standard office policies and procedures and ability to use office machines. 
• Working knowledge of electronic medical record programs, Microsoft Office programs and an intermediate excel user.

EDUCATION 

• High School Diploma/GED; Associate's/Bachelor's degree is a plus
• Must have a valid driver's license and proof of insurance
• Maintain CPR and First Aid Certifications 
• Billing and Coding certification is a plus 
• Billing and Coding associates degree is a plus

EXPERIENCE 

• 2 years billing and collections experience.  Work experience as a biller and collections worker is required.  
• 1 year billing and collections experience.  Work experience as a biller and collections worker in a Substance abuse or care facility is preferred.  
• Bilingual, able to read, write and speak Spanish proficiently is preferred.
• CA Drug Medical-Cal, experience with drug Medi-Cal and the state eligibility system is preferred.

PHYSICAL DEMANDS

The conditions herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

PHYSICAL: Work functions of this position are primarily performed in an office environment. Primary functions require sufficient physical ability and mobility; to stand or sit for prolonged periods of time; to occasionally stoop, bend, kneel, crouch, reach, and twist; to lift, carry, push, and/or pull light to moderate amounts of weight (up to 40 pounds); Manual dexterity of hands and fingers to include repetitive keyboarding, grasping, and reaching to operate a computer keyboard, mouse and/or standard office equipment.

VISION: Close, distant, and peripheral vision ability, including depth perception and the ability to adjust focus.

VERBAL:  Capable of clearly communicating with fellow co-workers, managers, and clients of the Center.

HEARING: Hear normal audio range with or without correction. Environment: this position works in a health care environment, and may be exposed to bodily fluids, odors, and cleaning products on an occasional basis. Additionally, this position has extensive client interaction and is subject to frequent interruptions.

EQUAL EMPLOYMENT OPPORTUNITY

It is our policy to abide by all federal, state and local laws prohibiting employment discrimination based on a person's race (including hair texture and hairstyles), color, religious creed, sex, national origin, ancestry, citizenship status, pregnancy, childbirth, physical disability, mental and/or intellectual disability, age, military status, veteran status (including protected veterans), marital status, registered domestic partner or civil union status, familial status, gender (including sex stereotyping and gender identity or expression), medical condition (including, but not limited to, cancer related or HIV/AIDS related), genetic information, sexual orientation, or any other protected status.

This job description does not list all the duties of the job. You may be asked by managers to perform other instructions and duties. This job description may be revised from time to time and does not constitute a contract for employment.