Third Party Reimbursement Specialist

Location
Fairfax, Virginia
Salary
$38,462.94 - $64,104.35 Annually
Posted
Apr 13, 2019
Closes
Apr 13, 2019
Ref
19-00723
Function
Administrative
Industry
Healthcare
Hours
Full Time
Job Announcement

Under general supervision of the supervisor of the third party billing team, the incumbent will perform these functions:
  1. Reconcile/post FOCUS workbooks
  2. Create/export Insurance worksheets and review incoming revenue
  3. Upload/quality check the scanning from authorizations and documents
  4. Process billing for Medicare, Secondary Medicaid & Injections
  5. Export payments from Credible to excel spreadsheet and upload to FOCUS
  6. Scan EOB to uploaded FOCUS documents
  7. Review uploaded claims/ review 277 report denials
  8. Record and apply payments from Medicaid/Medicare
  9. Prepare and enter Kaiser MCCP & MCCP Foundation billing
  10. other duties as assigned
Functional area: functional areas of behavioral health/medical care, fiscal management, reports, public contact, financial, and accounting.

Note
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Illustrative Duties

(The illustrative duties listed in this specification are representative of the class but are not an all-inclusive list.)
General Financial Duties
Uses spreadsheets or databases to organize information and produce standard reports;
Prepares a variety of complex disbursement forms (e.g., check requests, travel forms, cash sheets, and journal entries) for routing and approval;
May approve some disbursement forms;
Compiles and maintains monthly, quarterly, semi-annual, and annual totals, reports, and financial statements;
Explains fiscal rules and procedures to employees to ensure uniform application.
Fiscal Administration
Sets up accounts through corporate systems;
Reconciles ledgers;
Prepares status reports;
Gathers data for use by others in preparing budget;
Prepares transfer vouchers and interfund billing;
Monitors external accounts for discrepancies.
Accounting
Prepares wide variety of accounting forms;
Reconciles daily receipts or accounts receivable/payable;
Identifies discrepancies and makes corrections;
Collects required documents;
Prepares and authorizes expense vouchers and/or invoices within limited authorization levels.
Purchasing
Verifies requests for goods and services against county contracts and funding sources;
Orders goods or services and follows up/resolves discrepancies and ensures delivery;
Authorizes requests for goods and services in corporate systems;
Ensures appropriate routing and approval of purchase requests.
Scheduling & Coordinating for Others
Maintains calendar(s);
Schedules meetings;
Makes and cancels appointments;
Schedules rooms for classes, meetings, conferences, etc.;
Coordinates audiovisual, training equipment, refreshment requests;
Set up schedules for internal administrative staff to insure that they are available to meet changing work needs.
Communication
Composes routine correspondence on behalf of the executive/work unit head.
Office Management
Provides administrative support and implements procedures;
May supervise others;
Establishes/modifies and maintains a system for tracking the progress of work that is the responsibility of the executive/work unit head;
Trains and orients new employees;
Provides and explains relevant policies and procedures.
General Administrative
Composes routine correspondence on behalf of the executive/work unit head.
Receptionist/Public Contact
Schedule appointments;
Explains departmental policy/procedure but does not interpret them;
Responds to inquiries that require referencing a variety of sources and utilizing
knowledge of the department/county operations.
Word Processing/Typing
Keys/types complex documents (e.g., technical);
Proofs spelling and grammar;
Uses multiple software packages to prepare equations, statistics, tables and/or presentations;
Compiles reports from edited drafts;
Uses macros and templates developed by others.
Information Systems/Software
Performs data entry with some knowledge of department/work unit/program;
Manipulates screens for additional entries;
Generates routine reports;
Creates simple spreadsheets;
Maintains databases.
Reports
Compiles routine factual/numerical reports using readily available information.

Required Knowledge Skills and Abilities

(The knowledge, skills and abilities listed in this specification are representative of the class but are not an all-inclusive list.)
Knowledge of standard rules and interpretations within own functional area and a working knowledge of established methods and procedures used in related areas;
Significant nonstandard skill/knowledge is required involving production of an end product such as a report.
Word Processing/Typing
Basic skills in the use of Microsoft Word.
Math Skills
Basic math skills.
PC Skills
Basic skills in the use of applicable Microsoft Office Suite software.
Communication
Ability to write simple documents.
Information Abilities
Ability to process and integrate complex data.
Interpersonal Abilities
Ability to establish and maintain effective working relationships with both external and internal contacts.
Executive Assistance
Ability to maintain confidentiality and be sensitive to political issues.

Employment Standards

MINIMUM QUALIFICATIONS:
Any combination of education, experience and training equivalent to high school graduation and two years of experience providing administrative support in the assigned functional area(s).

NECESSARY SPECIAL REQUIREMENTS:
The appointee to this position will be required to complete a criminal background check, a Child Protective Services Registry, a driving record check, and sanction screening to the satisfaction of the employer. A TB screening upon hire and annually thereafter.

Applicants and employees within these select positions must demonstrate financial responsibility in personal finances as a condition of employment.

PREFERRED QUALIFICATIONS:
Prior one year experience in third party billing. Knowledge of mental health billing.

PHYSICAL REQUIREMENTS:
Ability to travel to various locations to attend meetings; walk up and down stairs; bend/stretch; carry up to 25 lbs. Ability to use the keyboard; retrieve/transport medical records; auditory/verbal to answer phones; visual to type/read charts; manual to fill out forms. All duties performed with or without reasonable accommodations.

SELECTION PROCEDURE:
Panel interview; may include exercise.

It is the policy of Fairfax County Government to prohibit discrimination on the basis of race, sex, color, national origin, religion, age, veteran status, political affiliation, genetics, or disability in the recruitment, selection, and hiring of its workforce.

Reasonable accommodations are available to persons with disabilities during application and/or interview processes per the Americans with Disabilities Act. Contact 703-324-4900 for assistance. TTY 703-222-7314 . EEO/AA/TTY.

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