BILLING ADMINISTRATOR

Job Purpose

Under the supervision of the Director of Operations, the Billing Administrator will be responsible for overseeing and submitting Fee for Service Billing through CareLogic electronic health record system, monthly vouchers through the fiscal intermediary as well as invoicing for private pay, DDD, Medicaid, and DVR.  The Billing Administrator demonstrates knowledge of JESPY House, Inc.’s quality mission, vision, and values. In addition, this position actively participates in quality improvement projects (i.e. communicating issues, offering suggestions) to ensure ongoing excellence for JESPY’s clients, staff, and programs.   This position is also responsible for assisting in the tracking of timely documentation submitted in the CareLogic electronic health record system.  This position is responsible with staying abreast of current trends as they relate to billing practices and staying aligned with best practices.

Essential Functions

• Learns and follows the Agency's policies and procedures by attending mandatory in-service programs given by the Agency.

• Act as a key player in implementation of the accounting billing module, through our Electronic Health Record (EHR).  Some duties include, but are not limited to, data entry and configuring activities. 
• Overseeing billing through our EHR including entering charges and submitting claims as well as additional set up tasks including:
  1. Entering ISP and SDR data in the billing module
  2. Setting up fiscal periods
  3. Configuring payers and billing types
  4. Inputting billing groups and billing info 
  5. Data entry of billing rates
• Ensure activities outlined in the Policy and Procedure Manual are followed for programmatic areas including: 
  1. Direct-care service that was provided has a valid prior authorization
  2. Claims include participant information and service information (such as Medicaid ID, diagnosis, procedure code, rate etc.) which can be found within the service plan and service detail report
  3. Service is properly documented along with any deliverable documents     necessary to substantiate the claim in the case of an audit (such as strategies, time sheets, behavior plans) 
• Handle accounts receivable reconciliation, claims corrections, and resubmission process
• Interact with payers (e.g. Medicaid, Insurers)
• Data entry from billing module to the agency accounting system
• Work as a team member of the Business Office
• Assist with Medicaid and DDD audits as required
• Business Office cross training as required
• Work with Director of Operations, Director of Quality Assurance and Medicaid Oversight Manager, and Business Manager as necessary

Reporting 

• Generate reports to be used to upload summary data on billing and accounts receivable into JESPY chart of accounts
• Maintain electronic and paper files of reports for internal and external uses
• Other related responsibilities as required

Competencies

1. Customer/Client Focus
2. Teamwork Orientation
3. Ethical Conduct
4. Problem Solving/Analytical
5. Accuracy and Attention to Detail
6. Technical Capacity
7. Confidentiality
8. Collaboration Skills

Commitment to Core Value

• Adhere strictly to HIPAA requirements and all agency confidentiality guidelines.
• Establish positive, balanced relationships with clients, as demonstrated by: 
  • treatment of individuals with respect and dignity and in an age and culturally appropriate manner;
  • a commitment towards the individual's rights and responsibilities; and
  • establishment of clear boundaries that allow for productive interactions. 

Reporting

n/a

Other Responsibilities

• Other responsibilities that may arise within the job scope
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. 

Educational Requirements

• High School Diploma
• Medical Billing Certification
• Accounting Background Preferred            

Work Experience Requirement

2 years medical billing experience

Skills/Abilities

• Comfort in learning new tasks as needed
• Proficient in CareLogic electronic billing system
• Knowledge of general billing practices and familiarity of International Classification of Disease (ICD) 10 
• Knowledge and comfort with working in an organization serving individuals with Intellectual and developmental disabilities
• Ability to use a computer to record activities, track equipment needs and communicate with management.
• Excellent computer skills; proficient in MS Word and Excel
• Detail oriented
• Experience in EHR a plus
• Other responsibilities that may arise within the job scope
• Excellent communication skills

Position Type/Expected Hours of Work

• Work week 9am – 5pm
   Must be available for department meetings on some weekends and after 5pm when required. 

Special Working Conditions/Physical/Requirements – Working Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

• Must be available for on some weekends and after 5pm when required. 
• Must hold a high school diploma
• Valid New Jersey driver's license is required
• Must hold CPR/First Aid Valid Certification (Will Train)
• Successful clearance of NJ background check
• Successful clearance of Drug Screening
• Has fulfilled the necessary training requirements and is in good standing in order to bill Medicaid for Support and Community Care Waiver (CCW) Services and  CDS

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.
• While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. 

Direct Reports

Assigned as required

Salary

Commensurate with experience

Notes/Comments

This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities or working conditions associated with the position.