Administrative Assistant V

Fairfax County • Fairfax (Ej32), VA

2d • Onsite

About The Position

Under the general supervision of the Financial Specialist II (FSII), this position supports the Fiscal Team of the Fairfax-Falls Church Community Services Board (CSB). This position plays a vital role on the Revenue Management Team, which manages billing, collections, tracking, and reporting for approximately $30 million in client and third-party fee revenues. Duties include responsibility for third party reimbursement functions and monitoring revenue cycle activities to analyze denial data and resolve issues. Works directly with insurance payers to determine reasons for denials, identify trends, and collaborate with all stakeholders to resolve denial matters. Conducts research on rejected claims to determine root causes, proposes solutions, and implements corrective actions. Leads communication with all parties to confirm denial details and files appeal by gathering and providing supporting documentation extracted from the electronic health records (EHR) system. Superior knowledge of timely filing requirements for each payer, the ability to address related issues, and strong prioritization skills are essential. Coordinates “no authorization” denials in collaboration with the Utilization Management Team (UMT) to obtain necessary updates, independently and proactively runs status reports on claims requiring authorization and works with UMT staff for resolution. Conducts research on denials related to ineligible providers and collaborates with Contracts and Credentialing staff to resolve them. It periodically plans actions to adjust non recoverable claims and makes recommendations to reduce denials and enhance fee revenue. Directs the process of generating automated payment reports and audits and reconciles payments to both manual and system generated documents to ensure accuracy in payment posting. The position is responsible for follow up on daily post processing activities, including re-issuing denied claim statements. Collaborates with insurance companies to resolve pending issues and shares findings with the supervisor, and leads communication with department contacts regarding accounting errors, billing issues, and necessary modifications. Responsible for timely overpayment correspondence to ensure compliance with applicable policies. Demonstrates appropriate knowledge of ICD 10, CPT, and HCPCS coding systems, as well as claim forms CMS 1500 and UB 04. Receives and evaluates billing requirements from the clearinghouse vendor, implements necessary changes, and disseminates relevant information. demonstrates initiative and the knowledge needed to research, understand, and resolve complex financial issues and is able to handle confidential and sensitive information. As a senior account representative, works directly with clinical staff and third-party payers to maximize revenue for CSB services. Develops procedures and implements processes to adapt to changing requirements of third-party payers and maintains knowledge of payer specific regulations and guidelines. Attends statewide conferences, local trainings, webinars, and other meetings to stay abreast of industry standards. Works with the DAHS PR Business Analyst and CSB Informatics staff to maintain EHR system settings that support efficient and effective billing and helps create and monitor productivity reports for use by Revenue Management Team staff, senior managers, and clinical staff. In collaboration with the FSII, manages and directs administrative staff responsible for third party reimbursement functions. The position manages and directs Administrative Assistant IVs in collaboration with the third-party team supervisor, leads efforts to develop performance standards and goals, and assesses performance on an ongoing basis, including annual pay for performance evaluations. Periodically reviews position descriptions and updates them as needed, participates in the hiring process by serving on interview panels, and makes recommendations for new hires to the supervisor. The ideal candidate will demonstrate excellent customer service skills with the ability to interact in a friendly, service-oriented, and professional manner with internal and external customers. Will be able to work both independently and as part of a team; be proactive; exercise good judgment; and apply strong critical thinking skills. Strong verbal and written communication skills are required, as well as advanced proficiency with Microsoft Excel (including PivotTables), Outlook, and Word. Must also be able to work with limited supervision, set priorities, and manage multiple tasks simultaneously. Functional areas: general administrative, medical or insurance billing, or finance Note: To learn more about careers that make a difference, watch our video " CSB Celebrates 50th Anniversary of Providing Care ."

Requirements

• High school graduation and four years of experience providing administrative support in the assigned functional area(s).
• Criminal background check, Child Protective Services Registry check, and sanction screening.
• TB screening upon hire.
• Basic math skills.
• Intermediate skills in the use of applicable Microsoft Office Suite software.
• Intermediate skills in the use of agency specific software applications.
• Ability to communicate well through written and oral means.
• Ability to speak in front of a group.
• Ability to gather, integrate, and analyze complex data.
• Ability to establish and maintain effective working relationships with both external and internal contacts.
• Ability to work with limited supervision, set priorities, and manage multiple tasks simultaneously.
• Knowledge of ICD 10, CPT, and HCPCS coding systems.
• Knowledge of claim forms CMS 1500 and UB 04.
• Knowledge of county policies within functional area of responsibility.
• Knowledge of an outside institution, dissimilar operational unit within the county or the basic principles and methods of a professional field.
• Thorough knowledge of the executive/work unit head's program/area and of county administration and organization.
• Ability to maintain confidentiality and be sensitive to political issues.
• Knowledge and sensitivity to issues, priorities, protocol, etc.
• Advanced proficiency with Microsoft Excel (including PivotTables), Outlook, and Word.

Nice To Haves

• Experience with and understanding of Generally Accepted Accounting Principles (GAAP).
• Experience in revenue cycle management, including handling insurance claims, payment postings, insurance follow-up, and denial and appeals processes.
• Experience using billing systems and electronic health record (EHR) platforms, including effective navigation of payer portals and documentation in the EHR that is professional, appropriate, accurate, and meets departmental quality standards.
• Experience interpreting and making decisions based on policies and procedures.
• Supervisory experience, including planning, organizing, coordinating, assigning, and evaluating the work of staff.
• Demonstrated experience resolving complex problems in a team-based environment, balancing multiple priorities, and making presentations to senior managers and groups.
• Bilingual in English and another language.

Responsibilities

• Supports the Fiscal Team of the Fairfax-Falls Church Community Services Board (CSB).
• Plays a vital role on the Revenue Management Team, managing billing, collections, tracking, and reporting for approximately $30 million in client and third-party fee revenues.
• Responsible for third party reimbursement functions and monitoring revenue cycle activities to analyze denial data and resolve issues.
• Works directly with insurance payers to determine reasons for denials, identify trends, and collaborate with all stakeholders to resolve denial matters.
• Conducts research on rejected claims to determine root causes, proposes solutions, and implements corrective actions.
• Leads communication with all parties to confirm denial details and files appeal by gathering and providing supporting documentation extracted from the electronic health records (EHR) system.
• Coordinates “no authorization” denials in collaboration with the Utilization Management Team (UMT) to obtain necessary updates, independently and proactively runs status reports on claims requiring authorization and works with UMT staff for resolution.
• Conducts research on denials related to ineligible providers and collaborates with Contracts and Credentialing staff to resolve them.
• Periodically plans actions to adjust non recoverable claims and makes recommendations to reduce denials and enhance fee revenue.
• Directs the process of generating automated payment reports and audits and reconciles payments to both manual and system generated documents to ensure accuracy in payment posting.
• Responsible for follow up on daily post processing activities, including re-issuing denied claim statements.
• Collaborates with insurance companies to resolve pending issues and shares findings with the supervisor, and leads communication with department contacts regarding accounting errors, billing issues, and necessary modifications.
• Responsible for timely overpayment correspondence to ensure compliance with applicable policies.
• Demonstrates appropriate knowledge of ICD 10, CPT, and HCPCS coding systems, as well as claim forms CMS 1500 and UB 04.
• Receives and evaluates billing requirements from the clearinghouse vendor, implements necessary changes, and disseminates relevant information.
• Demonstrates initiative and the knowledge needed to research, understand, and resolve complex financial issues and is able to handle confidential and sensitive information.
• Works directly with clinical staff and third-party payers to maximize revenue for CSB services.
• Develops procedures and implements processes to adapt to changing requirements of third-party payers and maintains knowledge of payer specific regulations and guidelines.
• Attends statewide conferences, local trainings, webinars, and other meetings to stay abreast of industry standards.
• Works with the DAHS PR Business Analyst and CSB Informatics staff to maintain EHR system settings that support efficient and effective billing and helps create and monitor productivity reports for use by Revenue Management Team staff, senior managers, and clinical staff.
• In collaboration with the FSII, manages and directs administrative staff responsible for third party reimbursement functions.
• Manages and directs Administrative Assistant IVs in collaboration with the third-party team supervisor, leads efforts to develop performance standards and goals, and assesses performance on an ongoing basis, including annual pay for performance evaluations.
• Periodically reviews position descriptions and updates them as needed, participates in the hiring process by serving on interview panels, and makes recommendations for new hires to the supervisor.
• Demonstrates excellent customer service skills with the ability to interact in a friendly, service-oriented, and professional manner with internal and external customers.
• Works both independently and as part of a team; is proactive; exercises good judgment; and applies strong critical thinking skills.
• Supervises a group of clerical/accounting personnel performing duties at the Asst. III level.
• Determines, modifies, and implements administrative policies, procedures and methods to improve office practices.
• Designs and uses spreadsheets and databases to interpret and organize resource information.
• Provides customized reports to analysts or others in the unit.
• Analyzes data and develops budget recommendations and projections for unit.
• Administers several complex funds, projects, contracts and/or grants.
• Processes journal and/or budget entries (e.g., change orders, accruals).
• Performs duties requiring entry level professional knowledge of basic accounting principles.
• Reconciles and monitors unit's accounting processes.
• Resolves non-routine and complex problems.
• Prepares wire transfers.
• Performs unique accounting functions that have department-wide impact.
• Researches and recommends equipment/vendors and prices.
• Determines substitutes for supplies and high value equipment.
• Coordinates the purchase of non-standard items (e.g., purchases requiring coordination with other departments, multi-fund purchases, and/or biohazardous material acquisition).
• Resolves issues and disputes with vendors and/or identifies need for increased levels of contract monitoring.
• Acquires insurance via county Risk Management.
• Provides advice and counsel to members of the executive/work unit head's functional area.
• Exercises discretion in administrative policy interpretation.
• Resolves a wide variety of operational problems requiring sound judgment.
• Acts as the liaison between the executive/work unit head's functional area, other county offices, and external agencies.
• Recommends exceptions to administrative policies that are subject to review.
• Supervises or handles the most complex, non-routine activities where consequence of error is high.
• Coordinates all logistic activities for visits by external groups.
• Schedules/sets up presentation rooms, obtains required audiovisual equipment, schedules order of presentations, length, etc.
• Verifies travel arrangements made by visitors (e.g., travel to/from hotel).
• Makes all arrangements required by visitors regarding catering or supplies.
• Directs or performs the scheduling, organizing, coordinating and making of arrangements for national and international meetings.
• Negotiates prices for goods and services required at meetings.
• Manages the calendar of the executive/work unit head with authority to make commitments of the executive/work unit head's time and to distinguish higher from lower priorities in the executive/work unit head's schedule.
• Independently composes original correspondence (e.g., preparation of replies to non-technical requests) for the functional area under their own signature.
• Explains and interprets policies as they apply to unique situations with potential legal and safety implications.
• Researches, coordinates, and provides information to others including citizens, executive/work unit head, and/or BOS members/staff.
• Informs internal staff regarding executive/work unit head's decisions regarding procedural issues and provides the reasons for those decisions.
• Supervises several dissimilar or specialized functions each with unique training requirements.
• Devises procedures for complex or specialized functions.
• Anticipates and develops procedures/tools to prevent problems; solves unusual problems.
• Provides administrative support to the functional area (e.g., reviews, evaluates and prioritizes all requests and communications; Analyzes short and long-range administrative needs such as space, staffing of functional area).
• Responsible for and determines administrative procedures.
• Answers questions requiring decisions that tend to establish a precedent and/or commit a unit or supervisor to a course of action.
• Recommends procedural changes.
• Interprets policies and provides oral and/or written interpretations/procedures for non-routine/complex problems referred by front line staff.
• Supervises word processing staff including training of staff.
• Edits for style, format, and/or layout.
• Trains staff in use of agency information systems/software.
• Researches & selects hardware/software.
• Creates complex spreadsheets for department.
• Operates/manages complex databases & other software using advanced functions.
• Diagnoses and resolves hardware/software problems using substantive computer/software knowledge.
• Prepares one of a kind reports, gathers statistics based on information compiled from various sources, draws conclusions, and makes recommendations.
• Supervises all personnel administrative functions for the department.
• Reviews new departmental policies for HR implications and recommends and implements administrative changes.
• Researches and recommends solutions to non-routine/one-of-a-kind problems.
• Drafts and coordinates approval of documents that include "boilerplate" language for matters related to HR (e.g., underfill agreements).
• Works with hiring manager to coordinate appointment and review process.
• Reviews class specifications and recommends requested job classification.
• Develops administrative HR-related procedures for agency.

Benefits

• Fairfax County Government prohibits discrimination on the basis of race, color, religion, national origin, sex, pregnancy, childbirth or related medical conditions, age, marital status, disability, sexual orientation, gender identity, genetics, political affiliation, or military status 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED