Medical Biller

Summary

To assist the Accounting Manager in the record keeping and financial reporting requirements of this Agency.  Must have good solid accounting skills.

Essential Duties & Responsibilities 

1. Primary responsibility for producing and submitting claims to multiple funding sources, including the State of Ohio, Medicaid, and Medicare for various programs.
2. Work directly with operational management in reviewing, appealing unpaid or denied claims within the standard billing cycle timeframe.
3. Maintain CareLogic software for behavioral health billing files.
4. Responsible for billing Senior Adult Care and specialty services.
5. Verification/Knowledge of participant authorization for services, via multiple websites, including MITS.
6. Keep up to date with the various funding sources rules and regulations concerning billable items.
7. Other duties may be assigned.
8. Must maintain the ability to pass a criminal background and drug screen.
9. Comply with all Agency policies, procedures and safety standards throughout work areas and maintain same to meet CARF, HIPAA, Department of Labor and other regulatory standards.

Supervisory Responsibilities 

None

Education Requirements 

• Minimum requirements are a High School Diploma.
• Some college education preferred.

Experience Requirements

• Five years’ experience in Medicaid billing and reimbursement.
• Knowledge of the Ohio Medicaid website and Managed Care Plans.
• Knowledge of Microsoft Office products, including Excel spreadsheets. 

Qualifications 

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
• The requirements listed below are representative of the knowledge, skill, and/or ability required.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Must maintain the ability to pass a criminal background check and random drug screens. 

Skills & Abilities

1. Must be able to work independently with little direct supervision as well as have the ability to work cooperatively as a team member.  
2. Must be able to follow through with projects and assignments in a timely and efficient manner.
3. Ability to deal with daily operational challenges in a fast-paced environment.
4. Must have working knowledge of Microsoft Office products, including Excel spreadsheets.
5. Must possess excellent customer service, organizational, writing, and reading skills.
6. Must possess excellent interpersonal skills with the ability to relate well with a broad spectrum of people; including consumers and employees.
7. Must be self-motivated.
8. Numbers-Detail.

Physical Demands

• The physical demands described here 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 functions.
• While performing the duties of this job, the employee is regularly required to sit and talk or hear. Specific vision abilities required by this job include close vision and ability to adjust focus. Detail in numbers. Computer Work and Data Entry.
• While performing the duties of this job, the employee is regularly required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; and talk or hear. The employee is occasionally required to climb or balance; stoop, kneel, crouch, or crawl; and taste or smell.
• The employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds, and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Work Environment

• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• The noise level in the work environment is usually moderate.

The above duties and responsibilities are essential job functions subject to reasonable accommodation. The employee must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job and/or apply for the position, absent undue hardship.This job description is not to be interpreted as an all-inclusive list of duties, responsibilities, or requirements. Employees may be required to perform additional job- related tasks as assigned, subject to reasonable accommodation.