Description
Summary
This position is critical to the Public Health Department and the County and is responsible for billing OHP, private and State programs, the revenue from which allows the department to operate programs more efficiently and effectively for the benefit of the general public. Position provides daily budget and grant updates including classifying, analyzing, and reconciling complex financial data and records resulting in accounting entries.

Distinguishing Characteristics
The Public Health Finance and Billing Specialist works under the general supervision of the Public Health Director and works closely with the Public Health Finance and Grants Manager.

Essential Duties
Essential Duties and Responsibilities

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Prepares billing statements to clients and a variety of medical insurance plans including Babies First, CaCoon, Maternity Case Management, Breast and Cervical Cancer, and Family Planning (FPEP), and other billable services.

• Enters client information into database for billing and statistical purposes, prepares periodic reports.
• Maintains and reconciles computerized billing spreadsheets, and posts all payment made to the Public Health and Environmental Health.
• Assists with renewal notices and issuing yearly licenses through the Environmental Health program.
• Serves as the Site Specialist for the OCHIN Electronic Medical Record (EHR).
• Provides back up to the Public Health Finance and Grants Manager.
• Serves as back up to the office staff in the areas of reception and preparation of clients to be seen in a clinic.
• Files and indexes billing paperwork in alphanumeric and by vendor, conducts record searches, maintains logs of public record documents.
• Performs data entry support primarily for services rendered for billing purposes.
• Utilizes computerized data entry equipment and various word processing, spreadsheet, and other related software programs to enter, store, and retrieve information as requested or otherwise necessary.
• Accesses and enters data into local, national, and internal databases and stays abreast of changes in reporting requirements.
• Completes claims to payers in a timely fashion.
• Submits billing data to insurance providers.
• Works on claims and claims denials to ensure maximum reimbursement for services provided.
• Collects, posts, and manages patient account payments.
• Prepares and reviews patient statements.
• Follows up to see if a claim is accepted or denied.
• Investigates rejected claim to see why denial was issued.
• Communicates effectively and regularly with leadership team members regarding progress and identification of potential database improvements, challenges, and conflicts.
• Manages the intake and entry of clients into billing system.
• Complies with data entry procedures and security policies.
• Preserves confidentiality and adheres to HIPAA regulations.
• Maintains and monitors data accuracy and logs errors to identify and report patterns.
• Develops support/remediation strategies as needed.
• Prepares for and conducts monthly budget meetings.
• Helps train new staff responsible for timely data entry and accuracy.
• Performs general clerical functions such as photocopying, filing, labeling, preparing/sending correspondence, reports, and other documents as needed.
• Identifies, compiles and codes patient data, using ICD-9/10 and CPT and other standard classification coding systems
• Reviews records for completeness, accuracy, and compliance with regulations.
• Identifies, analyzes, and resolves discrepancies in information that is not clear or in error; update databases and forms as needed.
• Assists in resolving all coding associated payer denials by pulling charts, missing operative reports, and gathering information requested by insurance company and/or supervisor.
• Assists with medical billing; ensuring compliance with Medicaid, Medicare and insurance carriers; develops guidelines and trains medical staff on coding issues and changes relating to regulatory compliance; and resolves billing problems
• Organizes and verifies patient records, bills, and payments; sorts and files paperwork.
• Ensures quality assurance and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statutes and laws relating to credentialing.
• Monitors accounts payable and receivables on a monthly basis.
• Maintains confidentiality of information.
• Serves as a member of the Public Health Emergency Preparedness and Response Team.
• Regular attendance is an essential function of the position.
• Performs other duties as assigned that support the overall objective of the position.

Qualifications
Knowledge
Knowledge of general office duties in a health or medical environment. Excellent accounting and communications skills, including handle multiple electronic billing systems. Familiar with Electronic Medical Records (EMRs). Demonstrated ability developing and monitoring complex budgets including but not limited to: understanding of budget terminology in local government; demonstrated ability to effectively interact with program and financial staff to facilitate budget development and execution. Knowledge and demonstrated ability applying generally accepted accounting principles (GAAP) including but not limited to: knowledge of the different methods of accounting (i.e. accrual, cash); demonstrated ability to interpret and apply existing, new, or revised accounting principles, standards, and concepts to make accounting reports accurate; demonstrated understanding of accounting terminology and application, and how to apply accounting principles and procedures to work products.

Skills
This job requires proficiency of computers skills including Microsoft Office (Word, Excel, PowerPoint, Outlook), Adobe Reader, e-mail, electronic calendar, and internet research; ability to compile, consolidate and summarize information; English grammar, spelling, written format and punctuation; effective verbal and written communication skills; significant attention to detail; demonstrated ability in gathering, analyzing, and presenting financial information using Microsoft Excel (proficiency is required).

Abilities
Ability to keep detailed and accurate records; competent with word processing and spreadsheet programs; ability to problem-solve and work in a congenial manner with clients, outside agencies and co-workers. Ability to comprehend and understand Local, State and Federal programs rules, regulations and guidelines pertaining to a variety of programs. Ability to maintain good communications with clients. Ability to promote clients right to confidentiality, quality services and respect.

Physical Abilities
Ability to sit at a computer using rapid wrist, hand and finger movement for an extended period of time. Ability to walk, stand, talk, stoop, kneel or crawl when necessary over uneven terrain. Ability to lift, push or pull up to 30lbs occasionally. Ability to communicate with others appropriately and effectively.

Education and Experience
Minimum requirement: Associate's degree in a related area from an accredited college or university AND one year of experience in a related area OR one year of professional experience in general accounting, billing and collection systems and/or claims. Additional experience working in a public health department, community based or medical organization in a business/financial/billing capacity or a closely related field may be substituted for the required education on a year-for-year basis up to two years.

Preferred requirement: Bachelor’s Degree in Accounting or Business Management with five (5) years’ experience in bookkeeping/accounting and responsibility for program or project monitoring and coordination, including two (2) years of contract review and monitoring.

Supplemental Information
Working Conditions
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. This position is considered health care personnel working in a healthcare setting that may have direct or indirect exposure to patients or infectious materials. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Usually works in a general office environment and uses a computer, telephone and other office equipment as needed to perform duties. The noise level in the work environment is typical of that of an office. Work also may involve travel to meetings. Incumbent may encounter frequent interruptions throughout the workday.

Working hours may be extended and highly stressful during an emergency situation. Travel may be necessary, requiring the operation of a motor vehicle, often to remote areas. The employee may be required to travel at nighttime or on weekends or in inclement weather to participate in program events or to respond to disaster events.

Probationary Requirement
This position is based on the successful completion of a nine-month probationary period and may be extended.

Next Review Date March 3, 2023

Job Type: Full-time

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