Financial Associate II - Billing Specialist

St. Croix County•New Richmond, WI

2d•$24 - $27•Onsite

About The Position

The Financial Associate II – Billing Specialist performs financial, accounting, insurance verification, billing, and consumer account functions for the Finance Department. Duties are assigned based on the position’s specific assignment and may include reviewing vendor invoices and entering charges into the Electronic Health Record (E.H.R.); reconciling general ledger accounts; preparing journal entries and deposits; and processing payments, adjustments, refunds, and claim disputes. The role also conducts financial interviews with consumers, verifies insurance benefits, obtains prior authorizations, reviews documentation, monitors authorized services, prepares appointment schedules, bills Medicare, Medicaid, commercial insurance, and self-pay services, and follows up on unpaid claims. The employee communicates account information and payment options to consumers, assists with medical assistance and family care applications, and provides Medicare Notices of Non-Coverage and support with appeals and denials. The position requires knowledge of governmental accounting and County policies and procedures, along with accuracy, confidentiality, sound judgment, organization, and effective communication. Work is primarily in an office setting.

Requirements

Associate degree in accounting, finance, business, management, or a related field, or an equivalent combination of education, skills, knowledge, and abilities.
At least two years of experience working in an accounting or bookkeeping position.
Knowledge of accounting, budgeting, and auditing principles, including GASB rules and GAAP standards, and their application to government accounting systems.
Knowledge of governmental accounting methods, procedures, and financial practices.
Knowledge of County programs, funding sources, and regulations governing expenditures and revenues.
Knowledge of public administration principles and practices, particularly governmental budget and finance administration.
Ability to prepare and maintain complex, accurate financial documents and reports.
Ability to perform detailed work accurately and independently under stringent time limits with minimal direction and supervision.
Ability to prioritize a high volume of work while adapting to changing priorities.
Ability to maintain accurate and legible notes and records.
Knowledge of County policies, procedures, practices, organization, and departmental operating requirements.
Ability to establish and maintain effective working relationships with others.
Ability to analyze research data and prepare organizational and functional reports.
Accurate typing and data-entry skills and ability to operate standard office equipment and perform word processing or data entry.
General knowledge of current office practices and procedures.
Ability to work the allocated hours of the position.
Effective written and verbal communication skills, workplace English proficiency, and spelling proficiency.
Ability to read County policies and procedures, written instructions, correspondence, safety materials, and related documents.
Ability to perform mathematical calculations and comprehend complex financial records.
Ability to respond to public complaints and grievances, follow verbal and written instructions, and interpret and implement policies, procedures, and applicable regulations.
Ability to define problems, handle varied situations, adapt to stress, and maintain self-control.
Ability to maintain discretion and confidentiality regarding business-related files, reports, and conversations, subject to applicable open records laws and regulations.
Organizational and time-management skills to meet deadlines, attention to detail, sound judgment, problem-solving ability, and ability to prepare accurate and concise records and reports.
Successful completion of a criminal background check is a condition of appointment.

Nice To Haves

At least two years of experience working in a nursing home, medical, or mental health field.
Experience with medical claim submission and compliance requirements within CMS (Centers for Medicare & Medicaid Services).

Responsibilities

Receive vendor invoices, review them for accuracy and contract rates, and enter charges into the Electronic Health Record (E.H.R.).
Reconcile general ledger accounts and prepare journal entries.
Conduct financial interviews with consumers in person or by phone to gather insurance information and verify assets and income to determine ability to pay.
Obtain required consumer signatures for releases, ABN, and billing paperwork.
Verify insurance benefits and obtain prior authorizations for services.
Review staff-submitted documentation for accuracy before submission.
Monitor service use and obtain additional authorizations as authorizations expire or approved visits are used.
Prepare the daily appointment schedule and review insurance notes and recent interview information.
Bill services to Medicare, Medicaid, commercial insurance, and self-pay accounts, and follow up on unpaid claims.
Sort, balance, and assign general ledger account numbers to cash, checks, credit card, and EFT payments.
Complete deposits, provide deposit documentation to the treasurer and other departments, and create journal entries to record deposits in the general ledger.
Apply payments to consumer accounts in the E.H.R.; make rate adjustments; initiate refunds for overpayments; and dispute incorrect claim payments or denials.
Communicate with consumers about payments and account balances and establish payment plans for past-due accounts.
Assist consumers with applications for medical assistance and family care.
Provide Medicare Notices of Non-Coverage and assist with appeals and denial processes.
Perform other duties as assigned.