ACCOUNTANT I - 64003398

State of Florida • Panama City Beach, FL

1d • $34,800 - $38,500 • Onsite

About The Position

This position performs a variety of complex support functions which require substantial technical, financial, administrative, and operational knowledge of accounting practices for the Florida Department of Health’s Medical and Dental programs. The duties of this full-time position will be dedicated to maximizing local accounts receivables through third party payers (Medicaid, Medicaid Managed Care, Medicare, private insurance companies/organization, etc.) for personal healthcare and dental services provided by qualified staff of the Florida Department of Health in Bay County (DOH Bay) (or other County Health Departments contracted with Bay County Billing Hub). The incumbent in this position will come to work and exhibit an attitude of friendliness and eager customer service towards all clients and act respectfully and courteously to fellow employees and clients. The incumbent in this position is responsible for the integrity and confidentiality of data sets under their control.

Ensures third party payments are accurately posted to the applicable client’s account within the Health Management Systems (HMS) and denied claims are researched and resubmitted within 30 days of when denial is received per DOH Accounts Receivable Policy, DOH 56-66-17. Works independently (and in conjunction with immediate supervisor, as needed) to solve billing problems by evaluating and researching using available tools and information to determine resolution of the claim to include crossover claims, corrected claims, appealed claims, Agency for Health Care Administration (AHCA) complaints, etc.

Processes both electronic and manual third-party claims for personal healthcare and dental services provided by the DOH contracted Billing Hub counties. This includes verifying client’s Medicaid, Medicaid Managed Care, Medicare, or any other third-party liability coverage, verifying client’s medical services are correctly coded (both CPT and ICD 10), correcting and rebilling any errors discovered, and verifying that correct billing practices are being followed. This also includes auditing services to include retro Medicaid billing.

Keeps the Account Receivables aging reports current. This requires direct face to face contact, computer contact, and telephone contact with Medicaid, Medicaid Managed Care, Medicare, or any other third-party liability company representatives to determine status of unpaid claims. Verifies and processes accounts that may meet the write-off, send to collections, and/or waiver criteria, initiates documentation for the DOH approval and processes through HMS monthly. Ensures client statements are printed and mailed monthly to clients who have an outstanding balance owed to the DOH contracted Billing Hub counties.

Maintains effective working relationships with the DOH contracted Billing Hub counties through constant communication using email, conference calls, telephone, fax, scanning, etc. Assists in completing provider credentialing and re-credentialing applications; may monitor applications and follows up, as needed. Maintains current and accurate data for all assigned providers.

Prepares statistical reports, as needed. Report may include number of third-party reimbursement claims by vendor, amount filed, amount received, number and amount of denied claims by vendor, reasons for denial, number of denied claims resubmitted for payment, number of client write-off accounts and amounts, number of accounts sent to state collection agency. Prepares trend reports as described above, beginning July 1 of current fiscal year and concurrently thereafter. Assists internal clients with HMS billing reports, as needed. Analyzes statewide revenue reports to assist in determining appropriate action plans to increase revenue collected by DOH.

Performs other related duties as assigned.

Requirements

• Knowledge and experience with medical billing procedures.
• Knowledge and experience understanding basic medical terminology.
• Ability to review and input data with 100% accuracy.
• Ability to use and learn varied computer programs to include HMS, Availity, FLMMIS, Microsoft Office.
• Ability to work independently with a sense of urgency to meet deadlines.
• Skills required: Attention to detail, time management, initiative, problem solving.
• Must have a current and valid driver’s license
• Must be able to learn and communicate effectively, orally and in writing, in English.

Responsibilities

• Ensures third party payments are accurately posted to the applicable client’s account within the Health Management Systems (HMS) and denied claims are researched and resubmitted within 30 days of when denial is received per DOH Accounts Receivable Policy, DOH 56-66-17.
• Works independently (and in conjunction with immediate supervisor, as needed) to solve billing problems by evaluating and researching using available tools and information to determine resolution of the claim to include crossover claims, corrected claims, appealed claims, Agency for Health Care Administration (AHCA) complaints, etc.
• Processes both electronic and manual third-party claims for personal healthcare and dental services provided by the DOH contracted Billing Hub counties.
• Verifies client’s Medicaid, Medicaid Managed Care, Medicare, or any other third-party liability coverage, verifies client’s medical services are correctly coded (both CPT and ICD 10), correcting and rebilling any errors discovered, and verifying that correct billing practices are being followed.
• Audits services to include retro Medicaid billing.
• Keeps the Account Receivables aging reports current.
• Contacts Medicaid, Medicaid Managed Care, Medicare, or any other third-party liability company representatives to determine status of unpaid claims.
• Verifies and processes accounts that may meet the write-off, send to collections, and/or waiver criteria, initiates documentation for the DOH approval and processes through HMS monthly.
• Ensures client statements are printed and mailed monthly to clients who have an outstanding balance owed to the DOH contracted Billing Hub counties.
• Maintains effective working relationships with the DOH contracted Billing Hub counties through constant communication using email, conference calls, telephone, fax, scanning, etc.
• Assists in completing provider credentialing and re-credentialing applications; may monitor applications and follows up, as needed.
• Maintains current and accurate data for all assigned providers.
• Prepares statistical reports, as needed.
• Analyzes statewide revenue reports to assist in determining appropriate action plans to increase revenue collected by DOH.
• Performs other related duties as assigned.

Benefits

• Annual and Sick Leave benefits
• Nine paid holidays and one Personal Holiday each year
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options
• Retirement plan options, including employer contributions
• Flexible Spending Accounts
• Tuition waivers

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed