OBJECTIVE/PURPOSE:

Under the supervision of the Controller and the support of the Senior A/R Coordinator, the Finance Generalist maintains current payer information on all applicable clients, demonstrates up-to-date knowledge of UCS fee policy, and processes accurate bills to ensure that payments to the Agency are received in a timely manner. Other duties in Accounts Receivable will include, but are not limited to, 1st Party backup, Medicaid Biller backup, and Credentialing/Managed Care backup. In addition, other duties in Finance will include, but are not limited to, Quarterly audits of CRT and DS client rep payee accounts, managing 3rd party insurance contracts, and auditing billing quarterly.

MAJOR RESPONSIBILITIES:

1. BILLING AND COLLECTION:

As a member of the A/R team, facilitates the processing of third party and Medicare statements via the creation of HIPAA compliant electronic files, direct online claims submission, and the mailing of "paper claims". Demonstrates a thorough knowledge of the UCS computer billing system. Investigates and updates third party and Medicare payer information as necessary; processes third party and Medicare payments, all related adjustments and reconciles the payment report to the Cash Receipts Journal. Monitors the timely receipt of payments from third party and Medicare and investigates denials in a timely manner. Reviews third party and Medicare delinquent balances and resolves with appropriate action. Investigates and processes third party and Medicare paybacks.

Provides the detail for the payback reconciliation to General Ledger and completes documentation (audit trail) for all billing adjustments processed including authorizations. Demonstrates knowledge of the relationship between first-party, Medicaid, and third-party reimbursements to maximize and expedite collected funds for any given service. Monthly; create Special Billing for programs and roll-up services separately. Track KPIs as assigned.

Plays an active role in interfacing with IT and Electronic Health Records staff to resolve A/R and billing problems as they arise to assure all Agency regulations are met and adhered to. Acts as backup for the Senior A/R Coordinator Medicaid Biller, First Party and the Credentialing/Managed Care positions. Actively participates in Basecamp, weekly, and other meetings. Month end reconciliations including timely closing of the month.

1. CLERICAL:

Keypunches all above-related data, demonstrating a clear understanding of codes before inputting to the computer. Organizes and maintains all third party and Medicare files. Corrects data errors as needed.

1. OTHER:

Reports on third party and Medicare accounts receivable in monthly A/R meeting. Completes quarterly audits of CRT and DS rep payee accounts, manages 3rd party contracts, audits billing quarterly, and special projects or other duties as assigned when Agency need requires.

* In addition to the above, performs other duties as assigned.

EDUCATIONAL REQUIREMENTS:

High School Diploma or equivalent with 3 - 5 years of relevant experience. Computer skills required.

PI249777345