Pay Range: $17.75 to $19.75 Hourly
MAJOR DUTIES: The RCM Billing Assistant position works under the supervision of the RCM Manager. The incumbent is tasked with working the front end of the revenue cycle which involves reviewing insurance and funding eligibility, reviewing service and claim data to resolve issues prior to billing out services. Data enters information to maintain database(s) and review information to ensure the agency’s ability to bill. The incumbent is responsible for accuracy, efficiency, and retrieval of processed data. The position includes proofing material entered and generating data reports as required. In fulfilling these duties, the incumbent performs the following duties independently:
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Works with the local EBT food benefits office to request temporary EBT cards for patients in some of the above programs, manages the cards, calculates the funds to be collected, determines when to return funds. Manages data related to EBT processes and works closely with the local government officials who oversee the EBT program.
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Confirms and updates patient and insurance information by checking third party sources and by contacting the patients and insurance companies; creating and processing 270/271 EDI files.
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Assist people in receiving services and families to access benefits, including Medicaid, and enroll in programs that may benefit them.
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Provide patients access to WA Apple Health BH Services Booklet. Apple Health client booklets | Washington State Health Care Authority
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Reviews and manages the billing of the FCS program services.
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Data enter service activities into Carelogic EHR.
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Prepares and uses reports necessary for billing services and reporting patient encounters, using spreadsheets or database systems and reports data to Accounts receivable for invoicing, or approving and billing claims.
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Works closely with clinical staff to enroll patients with NS ASO funding, obtain authorization for NSASO payer, review and submit state reporting data, and claim files to an SFTP site.
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Prepare invoices for submitting to certain payers using reports submitted by programs or ran in the EHR.
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Enters data into state data repositories for specific populations.
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Review and approves payments in a 2nd step approval process.
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Picks up and processes mail received in the billing office.
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Assists the RCM team as needed.
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Complete training and attend weekly staff/other meetings.
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Complete the training for Apple Health/Medical insurance. Community-based training | Washington State Health Care Authority
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Maintains strictest confidentiality; adheres to all 42 CFR part 2 and HIPAA guidelines/regulations.
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Able to problem solve issues and apply them to daily problems that occur.
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Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation.
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Communicates with clinical staff and with technical staff to resolve issues.
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Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function.
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Works as part of the agency’s revenue cycle management team.
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Supports and implements agency policies and procedures.
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Performs special projects related to data entry, reporting, and billing as assigned by supervisor.
KNOWLEDGE AND SKILLS REQUIRED BY THE POSITION
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High School diploma or equivalent.
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Minimum of one year’s experience in clerical, data entry, or billing role, preferably in a medical environment.
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Experience with insurance billing, Medicaid billing, use of ProviderOne, and/or knowledge of behavioral health services strongly preferred.
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Prior experience with Qualifacts’ CareLogic electronic health record preferred.
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Ability to produce accurate information and reports using Microsoft Excel.
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Ability to communicate clearly and effectively.
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Great attendance.
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Ability to work well with others.
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Must be highly organized, detail oriented, able to work in a changing environment, and possess good analytical skills.
GUIDELINES
Requires that the incumbent relies on specialized training and/or equivalent experience and performs duties in accordance with Washington Administrative Codes, Federal regulations governing the confidentiality of patient files, and Lifeline Connections Policy and Procedure Manual.
PERSONAL CONTACTS
Contacts are with the members all agency departments and programs, consumers, significant others of the consumers, and representatives of various community agencies specializing in the treatment of chemical abuse and mental illness. All personal contacts are carried out in accordance with federal and state laws dealing with the confidentiality of patient records.
PHYSICAL DEMANDS
While performing the essential functions of the job, the employee is regularly required to sit, speak clearly, hear, and use hands and fingers to manipulate writing utensils and keys on a keyboard.
WORKING ENVIRONMENT
Working hours are spent indoors in offices or other meeting rooms. Participation in staff retreats and staff development activities will be required.
IMMEDIATE SUPERVISOR: Revenue Cycle Management Supervisor