JOB DUTIES AND RESPONSIBILITIES 

Billing:

• Perform daily and monthly billing cycle management.
• Perform daily insurance, private-pay, and Medicaid billing submissions to Change Healthcare. 
• Perform insurance and Medicaid billing cycle submission reconciliation.
• Perform monthly contract billing.
• Other billing duties as assigned.

Accounts Receivable:

• Responsible for timely collection of self-pay, insurance, and Medicaid MMA.
• Amounts past 30 days are considered past due
• Communicate with clients, insurance companies, Medicaid MMA, reference outstanding balances
• Prepare and mail patient statements monthly.
• Must follow statement mailing policy.
• Current laws state that patients must be properly and timely informed of patient responsibility balances ? no surprises are permitted
• Post payments and apply to open balances daily ? real time.
• EOBs must be processed daily ? real time.
• Process patient refunds timely
• Often, insurance companies process a claim different than what is communicated during the benefit verification process
• If an insurance company pays more, resulting in an overpayment of patient responsibility ? a refund must be processed within 3 days of insurance payment receipt
• Returned patient refund with no forwarding address must be reported and paid to Florida Unclaimed Property during the week returned payment was received. 
• Patient account balances past 90 days, with multiple attempts to collect must be turned over to the collection agency 
• Confirm patient has discharged
• If not discharged, communicate with senior management timely, in an effort to collect prior to completing services
• Write off adjustment reason:  collection
• Collection package must be uploaded into the client record in Welligent ? Attachments
• Accounts must exceed $100 in order to be sent to the collection agency
• Collection packages but be signed of by Controller and CoS, whose over all programs.
• Insurance and Medicaid claims denied for payment must be considered as a transfer to CFBHN for outpatient, LSF for residential
• Patient must have the required documentation prior to transfer
• Denial notice must be uploaded in the client record in Welligent - Attachments
• Timely resubmittal of appeals for denied claims.
• Responsible for month-end close reports.
• Stored in SharePoint
• A/R and Adjustment Monthly Reports ? to be shared with CoS and other applicable staff during bi-weekly A/R Meetings
• Performs all other duties as assigned
• Required Industry Standard Key Performance Indicators (KPI):
• Net Collection rate (NCR) will be greater than 98%. 
• Denial rate of insurance payment will be less than 3%.
• First Pass Rate will be greater than 97%.
• Days in A/R will be less than 25 days.
• Third part fees will be billed 100% of the time within the timely filing deadline.
• 100% of financials will be updated in E.H.R within 24 hours of receipt.
• 99% accuracy on entering information in E.H.R.
• 100% of required trainings will be completed within specified time frames.
• Required Knowledge, Skills, and Abilities:
• Must be a self-starting, team working, interpersonal skills, and ability to learn quickly. 
• Superior verbal and written communication skills. 
• Ability to manage variety of tasks concurrently. 
• Strong customer service and commitment requiring minimal supervision. 
• Working knowledge of federal, state, and local employment laws. 
• Ability to maintain confidentiality relating to compensation, future management decisions and/or changes, and sensitive employee issues. Discuss related matters up the organizational hierarchy, and not with subordinates and coworkers. 
• Skillful at multitasking and attention to detail in a fast-paced environment. 
• Excellent verbal and written communication and interpersonal relationship skills. 
• Excellent time-management, decision-making, and organization skills. 
• Ability to maintain a good working relationship with all co-workers and the general public and to use good judgment in recognizing scope of authority. 
• Ability to remain calm in stressful situations. 
• Ability to take a teamwork approach to the job by cooperating with others, offering to help others when needed, and considering larger organization or team goals rather than individual concerns. This includes the ability to help build a constructive team spirit where team members are committed to the goals and objectives of the team. 
• Demonstrated teamwork qualities: ability to motivate and work with people, extraordinary communication skills, both written and verbal. 
• Demonstrated ability to utilize an electronic clinical management system 
• Proficiency in Microsoft Windows, Office (Word, Excel, and Access) and internet capabilities. 
• Ability to operate general office equipment in the completion of job responsibilities. 
• Effective oral and written communication skills ? Can produce written communications that are understandable and grammatically correct; listens to understand; and openly and honestly communicates with supervisor, peers, and subordinates (if any). 
• Ability to receive and internalize coaching - willingly asks for and accepts performance feedback from supervisor, peers, and subordinates (if any) and uses that input to grow, develop, and improve overall effectiveness. 
• Ability to work within a Team structure ? can work effectively within a team environment and can look beyond an individual success to recognize the importance of achieving a Phoenix House success. Functions as a problem solver? sees obstacles as challenges to meet and overcome, not as impossibilities; emphasis is on finding solutions to problems Generates invoices and processes payments. 
• High energy level ? has a bias for action and a strong work ethic. 
• Is accountable ? takes personal responsibility for actions and for achieving outstanding performance results; has a commitment to excellence. 

Required Education and Experience: 

• Bachelor's degree in accounting, finance, or related field. 
• At least 3 years' experience in a similar role.
• Must have a solid understanding and demonstration of insurance regulations and insurance payers, as well as insurance portal.
• Strong math, typing and computer skills, especially with HER platforms.
• Excellent communication, research, problem-solving, and time management skills.
• High level of accuracy, efficiency, and accountability.
• Attention to detail.
• Ability to build relationships with our clients and internal organization departments.
• Certification in Billing and Coding, preferred. 
• Proficient in all Microsoft Office applications. 
• The ability to work in a fast-paced environment. 

LICENSES/CERTIFICATIONS/CEUs:

• Certification in Medical Billing and Coding (Preferred) 

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties and responsibilities of this position.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential duties and responsibilities. 

REGULARLY REQUIRED:  to sit, use arms/hands to reach, manipulate, handle, or feel objects, tools, or controls; written and verbal communication, ability to hear.

OCCASIONALLY REQUIRED: to stand, walk, stoop, kneel or crouch and lift and/or move up to 10 pounds. 

WORK ENVIRONMENT 

The work environment characteristics described here are representative of those an employee encounters while performing the essential duties and responsibilities of this position. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential duties and responsibilities. 

• The work environment is that of a substance use treatment milieu which may include: 
• Exposure to clients infected with Hepatitis B, HIV, TB, or other Infectious Diseases 
• Business-related travel may be required. 

SCHEDULING NEEDS: None noted.

Phoenix House Florida is an Equal Opportunity Employer, and all qualified applicants and team members will be considered for employment and advancement without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, national origin, age, marital status, disability, genetic information, military or veteran status or any other characteristic protected by federal.

Location: Brandon, FL