JOB DESCRIPTION



Autism Delaware Inc.

Job Description

JOB TITLE: Billing Associate, part-time

DEPARTMENT: Billing

REPORTS TO: Billing and Coding Coordinator

EFFECTIVE DATE:

FLSA: Non-exempt

SUMMARY:

The Billing Associate is responsible for billing and coding for agency insurance reimbursable services, grants, and contractual services; and for tracking the status of authorizations, invoicing, and payments for program services to ensure funding compliance This position will become a member of the billing team and work collaboratively with program leaders to ensure billing processes are maintained and improved and areas of risk are reduced.

The individual must demonstrate strong knowledge of billing and coding reimbursement systems. They must be able to share that knowledge effectively in the form of meetings, presentations, and consultation with professionals. The Billing Associate maintains relationships with funders through phone contact, emails, and/or face-to-face meetings.

The Billing Associate works under the supervision of the Billing and Coding Coordinator. This is a part-time position requiring an estimated 29 hours a week.

DETAILS:

ENTRY LEVEL QUALIFICATIONS:

1. Experience with billing and coding reimbursement systems

2. Good oral and written communication skills

3. Strong skills in a variety of software applications

4. Strong organizational skills

5. Valid driver’s license

QUALIFICATIONS FOR CONTINUED EMPLOYMENT:

1. Adherence to all policies and procedures

2. Punctual and regular attendance as scheduled

3. Successful, safe, and effective implementation of job tasks

4. This job description in no way states or implies that these are the only job duties to be performed by the incumbent. They will be required to follow any other instructions and to perform any other duties requested by their supervisor.

WORKING CONDITIONS:

This position is a part-time hourly position. General hours of operation 8:30 AM to 5:00 PM. Travel to other locations may be required.

JOB RELATED DUTIES

ESSENTIAL FUNCTIONS:

1. Understands and demonstrates agency and department’s commitments, mission, vision, and values

- Actively participates in meetings, demonstrating self-awareness, responsibility, initiative, and professionalism.

- Is flexible and accommodating in unplanned or crisis situations.

- Seeks and accepts help and direction freely and when needed.

- Demonstrates follow-through on team’s goals and plans.

- Demonstrates a commitment to ongoing professional development through the study and practice of new skills and knowledge in the field.

2. Effectively manages issues related to billing and coding

- Is available for phone consultations with funding sources as well as face-to-face meetings.

- Gathers Medicaid and other applicable insurance billing information by reviewing client records and checking for completeness.

- Ensures payments by verifying accuracy of Medicaid/insurance coding.

- Bills Medicaid/insurance by inputting billing information to state database and initiating electronic transmissions.

- Resolves disputed claims by gathering, verifying, and providing additional information, following-up on claims.

- Prepares reports of Medicaid/insurance billing by summarizing billings, adjustments, and revenues received.

- Completes authorizations and referrals for services, including contacting providers, completing initial applications and reauthorizations, discharges, and follow-up with agencies on issues related to authorization.

- Reviews client’s history and insurance coverage for approval.

- Contacts referring physicians and agencies for additional information as needed.

- Inputs client information and updates information in our database systems.

- Communicates with supervisor regarding issues relative to authorizations and Medicaid/insurance.

- Coordinates with Intake Coordinators to ensure smooth and timely authorizations and discharge.

- Successfully assesses needs and problems in areas of responsibilities and formulates solutions as needed.

- Monitors areas of responsibility for risk and compliance and intervenes effectively to manage these areas.

3. Works effectively with team to ensure excellent service delivery

- Represents Autism Delaware effectively.

- Leads or works closely with other professionals supporting services.

- Must be flexible and responsive regarding service and participant need in order to ensure sensitive and solution-based approaches to service changes.

- Seeks opportunities for improving management of resources.

4. Effectively and professionally manages documentation

- Provides clear, accurate, and thorough reporting of billing issues in a timely manner.

- Maintains excellent notes and submits all required documents in a timely fashion.

- Handles billing for all areas of assignment.

- Ensures that files are maintained in accordance with HIPAA standards.

NON - ESSENTIAL FUNCTIONS:

1. Participates in agency functions.

2. Safely manages all aspects of job responsibilities:

- Maintains a safe and hazard–free work area. Effectively monitors facilities and equipment for cleanliness and hazards. Raises concerns when appropriate.

- Identifies potential program risks and brings these issues to the attention of the appropriate people immediately.

Salary negotiable, depending on experience.

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