Billing and Clerical Manager

POSITION SUMMARY:

Under the supervision of the Pottawatomie County Health Department Director, the Billing and Clerical Manager is a non-exempt position under FLSA. The job duties of the Billing and Clerical Manager include but are not limited to responsible for administrative duties of clinics in office and in the community setting, as well as administrative, and supervisory of administrative secretary-receptionist and Community Health Workers. This employee plans, organizes all office duties to include electronic health record management, ordering and accurate billing to maintain constant cash flow, assure all procedure codes are correctly inputted for all KanCare Medicaid, private insurance and Medicare programs according to state regulations, and to provide responsive, courteous and efficient service to County residents and the general public. Also functions as the Health Department’s Billing Administrator updating clinic data system, running billing reports keeping current with program changes, etc. 

ESSENTIAL FUNCTIONS (required):

1. The Billing and Clerical Manager is considered part of the administrative team at the health department, this person is responsible for the supervision of the clerical staff including training, planning, assigning and directing work, performance reviews disciplining employees, addressing complaints and resolving problems. 
2. Overseeing orientation of the new clerical staff along with coordinating staff training of yearly updates to meet state and HHS requirements for HIPAA and financial requirements for auditors. 
3. Coordinate an effective system to meet the needs of the health department clinics to provide services to the residents of Pottawatomie County. 
4. Responsible for the development and maintenance of clerical policies and procedures including documentation into the electronic health record system.
5. Prepares Health Care Financing Administration (HCFA) or other forms necessary to submit electronically or by paper for collection of service charges by private insurance, Medicaid, and Medicare; 
6. Manages and maintains resources for Current Procedural Terminology (CPT) procedure codes and International Statistical Classification of Diseases and Related Health Problems (ICD) diagnostic codes and guides staff on proper coding standards; 
7. Utilizes appropriate software to prepare and submit bills and correspondence for accounts due, insurance deductibles, co-pays and insurance details;  
8. Responsible for all aspects of the billing and collection process for Health Department and back up person for EMS;  
9. Confirms and documents all revenues received into the department, and reconciles end of month/year;
10. Performs other routine administrative duties such as but not limited to data entry, requests for refunds, deposits, mailings, balancing account ledgers, filing, typing correspondence, and records management; 
11. Monitor, calculate and send monthly account receivable statements for clinic services;
12. Work collaboratively with staff to maintain a team environment and accomplish the tasks necessary to serve and support department and stakeholders;
13. Develop and deliver organized communications with Department Director regarding proposed changes, developments, and opportunities affecting the front office, billing and other activities assigned; Provides input on yearly goals and strategic planning for the health department
14. Keep updated credentialing with all insurance companies & Medicare/Medicaid;
15. Prepares and verifies expense vouchers for department, submitting for payment as per County policy;
16. Monitor and update clinic data system, running billing reports, keeping current with program changes, insuring appropriate staff is educated and trained to use system, etc. 
17. Assist clerical staff and office personnel with daily functions including but not limited to, answering telephone lines, assisting with public; prepare clerical supplies for clinics, etc; assist with satellite clinics as needed, requiring some travel;
18. Comply with federal, state and local laws and regulations including maintains patient’s Protected Health Information confidentiality as per the HIPAA regulations; keeping records in an organized concise manner, integrated with other health department records. Functions as the HIPAA officer for the Health Department responsible to ensure department is in compliance with all HIPAA regulations; facilitates the training for the department for all HIPAA Training for Privacy and Security. 
19. Reliable and dependable attendance mandatory.

MARGINAL FUNCTIONS

1. Attend and participates in training, educational sessions and/or meetings as required or requested to maintain billing credentials;
2.  Assist with yearly cost analysis and fee schedule maintenance;
3. Participate in continuous quality improvement efforts;
4. Assist with Public Health Emergency Preparedness activities as necessary;
5. Implement changes as requested to ensure forward progress;
6. Identify and implement solutions to problems in general seeking counsel as appropriate;
7. Partner with management to ensure the best possible service and effective communications that coordinate and support organization goals;
8. Prepare and present various reports to supervisor as requested or deemed necessary;
9. Maintain cross training with the knowledge and ability to perform front office, billing, and other activities assigned within the office;
10. Actively seek to add and enhance knowledge regarding developments and current trends in the industry that will serve Pottawatomie County Health Services business needs;
11.  Assumes responsibility for own professional growth and development by pursing education, participating in professional committees and work groups and contributing to a work environment where continual improvements in practice are pursued; 
12. Maintains Health Department inventory and other monthly reports, assist with ordering and storage of supplies, etc.;
13. Performs other duties as assigned or deemed necessary.

KNOWLEDGE, SKILL AND ABILITY:

The employee in this position must exercise considerable independent judgment based on knowledge gained through experience in the performance of these specialized duties. It is expected they act independently in filing, collecting, posting, verifying medical claims, depositing, and reconciling all department revenues associated with such programs and procedures. This position may deal with past due accounts and the collection of the nonpaying accounts. 

In addition, the employee is expected to collaborate with a variety of health care providers, insurance companies, state and federal agencies, and department clientele to acquire and maintain obligatory claim submission and reimbursements. The employee in this position will ensure department is in HIPAA compliance at all times. Employee must conform to HIPAA privacy regulation specific to the position held. The employee creates and records protected health information (PHI). The employee is only authorized to use the information for categories for work performance. Disclosures are only allowed as necessary for treatment or to other providers/business associates or as required by law. Access to PHI and information is only allowed for health care operations.

The ability and willingness to learn basic accounting principles, including general ledger, accounts receivable/payable, medical coding and insurance billing. Must possess extreme attention to details with excellent time management skills. Skills in operating office machines such as computer, copier, calculator, typewriter, fax machine, and other standard office equipment. Employee must possess a working knowledge of medical terminology and medical billing codes. 

Skilled in oral and written communication. Can write routine reports and correspondence with proper grammar and spelling; respond to inquiries by telephone of clients who may come into the office. Can speak effectively before groups of customers or employees of the organization. Knowledge of all office billing policy and procedures, department programs and health related information within 3 months of hire.

EDUCATION/TRAINING/EXPERIENCE:

Education: High School diploma, or GED and valid Driver’s License are required. Associate’s degree in accounting, business, business management preferred, or equivalent combination of education and experience. Will have any required credentials within 6 months of employment. 

Experience: Two to five years of medical billing, bookkeeping, other similar or related experience is required. Employee is expected to have acquired the necessary information and skills to perform the job reasonably well within six months of employment.

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

The work environment and physical demand characteristics described here is representative and not intended to be fully inclusive 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.

Professional office setting with little discomfort due to such factor as noise heat, dust or other adverse factors. Duties performed offsite are exposed to weather conditions of extreme temperatures, chemical, fumes, work safety hazards, dust, loud noises, darkness and tight spaces, travel associated travel risks. This is a tobacco and tobacco like free work environment, including all County premises and other such areas as outlined in Employee Handbook. The person may be at risk of exposure to communicable disease and blood borne pathogens as back up to front office staff. The person is expected to endure high levels of stress and frustration associated with billing and collection.  

Work is primarily sedentary the duties of this job may require ability to exert up to 25 pounds of force, and lift, carry, push, pull or otherwise move objects up to 50 pounds. This position requires the ability to; sit stand and walk for extended period of time, as well as, balance, climb, crouch, kneel, stoop, and bend occasionally. Frequently use hands to feel, reach, and grasp objects, tools or controls. Vision abilities for close and distance vision, color vision, peripheral vision and depth perception.

PROBLEM SOLVING:

Independent decision-making and problem solving is major factor in this position. This employee encounters problems concerning the data entry of incorrect information into the computer system. Must have the ability think critically, to concentrate on detailed information and handle a variety of complex decisions (normal to above average range). While using sound judgement and deductive reasoning.

DECISION MAKING:

Independent decision-making is a major factor in this position. Employee must decide the most efficient method for performing essential functions, data entry and information. This employee makes decisions regarding clients concerns, prioritizing daily work assignments and dealing with insurance companies. 

MACHINES/EQUIPMENT USED:

Computer Copier Printer Scanner 

Multi-line phone Facsimile Shredder Personal/county vehicle

Postage Meter Typewriter 10-key Other office equipment

SUPERVISION/ACCOUNTABILITY:

This employee must meet deadlines and work under pressure with little or no direct supervision.

FINANCIAL ACCOUNTABILITY:

Has some responsibility for departmental equipment and resources. Is responsible for receipting of money, but does not participate in the annual departmental budget process. 

PERSONAL RELATIONS:

Daily contact with the general public, co-workers, other county employees, supervisory personnel, and elected or appointed officials is expected. This employee will exercise tact, initiative and good judgement dealing with daily contacts using excellent customer service.  

Will be professional and cordial interactions with clients, community partners, staff and others at all times. Contributes to a work environment that fosters ongoing respect, professionalism and team cohesiveness.