FISCAL ASSISTANT I - 64003878

State of Florida • BUNNELL, FL

3d • $34,758 - $43,533 • Onsite

About The Position

This is a highly responsible Fiscal Assistant I position in the Billing/ Fiscal Department at the Flagler County Health Department. Fiscal Assistant I, processes financial records which require independent decision making and judgment. Duties involve processing Medicaid HMO’s, Medicare and third party/commercial insurance claims. Responsible for reviewing insurance web portals for eligibility, deductibles, co-pays, co-insurances and payments. The position is responsible for a cash draw to receive payments form clients and must balance receipts daily. This position maintains a variety of complex accounting and financial records in Accounts Receivable reporting. This position also determines eligibility for a variety of State and Federal programs. The position reports directly to Operations Management Consultant 1.

Audits, analyzes and reviews encounters and verifies all insurance information; makes the necessary determination as to the correct insurance, and processes all claims accordingly. Researches claims for Medicaid, Medicaid HMO’s, Medicare and other third-party insurance. Contacts insurance carriers when necessary to re-evaluate claims for payment. Processes payments and works denials according the Accounts Receivable Policy timelines. Responsible for collaborating with other departments, if necessary. Reviews claims for ICD-10 codes for accuracy. Runs appropriate HMS system reports to monitor and evaluate the Medical billing process for Medicaid, Medicaid Managed Health care Plans (MMA’s), and Medicare and third- party accounts receivables. Create and Maintain Denied Claims reports on all MMA plans. Develop training documents (cheat sheets) and on-going training on proper coding and billing which includes understanding modifier, CPT codes and ICD-10 for billing staff. Files complaints to The Agency for Health Care Administration, due to billing issues with MMA Plans. Reviews medical record to make sure appropriate CPT and diagnosis codes are utilized prior to sending bill file. Creates and maintains CAQH files on all Flagler County Health Department providers.

Performs duties assisting Fiscal Assistant I (FA1). Runs appropriate HMS system reports including the Unbilled report. Generates Bill File Creation, which produces the Medicaid Billing File in the absence of other staff. Determines client’s eligibility for a variety of State and Federal programs. Verifies and updates client’s demographics as needed. Inputs charges and payments for private paying client services in CHD HMS system. Access to Social Security Data, Clinical information for services provided.

Additional duties as requested by supervisor

Requirements

• Ability to multi-task, problem solve and use independent judgment.
• Ability to correspond in writing and explain details to clients.
• Ability to conduct in-depth interviews for program eligibility.
• Must be willing to accept the offered salary.
• Must be willing to physically come in the office to perform the duties and responsibilities of the positions.
• Must have current authorization to work in the United States without employer sponsorship.
• Must have at least 1 year of dental or medical billing experience.
• Ability to learn and communicate effectively, orally and in writing, in English.

Nice To Haves

• Extensive knowledge of insurance web-portals.
• Ability to understand clients coverage.
• Ability to process claims and work denials.

Responsibilities

• Processes financial records requiring independent decision making and judgment.
• Processes Medicaid HMO’s, Medicare and third party/commercial insurance claims.
• Reviews insurance web portals for eligibility, deductibles, co-pays, co-insurances and payments.
• Responsible for a cash draw to receive payments from clients and must balance receipts daily.
• Maintains a variety of complex accounting and financial records in Accounts Receivable reporting.
• Determines eligibility for a variety of State and Federal programs.
• Audits, analyzes and reviews encounters and verifies all insurance information.
• Researches claims for Medicaid, Medicaid HMO’s, Medicare and other third-party insurance.
• Contacts insurance carriers when necessary to re-evaluate claims for payment.
• Processes payments and works denials according to Accounts Receivable Policy timelines.
• Collaborates with other departments if necessary.
• Reviews claims for ICD-10 codes for accuracy.
• Runs appropriate HMS system reports to monitor and evaluate the Medical billing process.
• Creates and maintains Denied Claims reports on all MMA plans.
• Develops training documents and provides on-going training on proper coding and billing.
• Files complaints to The Agency for Health Care Administration due to billing issues with MMA Plans.
• Reviews medical records to ensure appropriate CPT and diagnosis codes are utilized prior to sending bill file.
• Creates and maintains CAQH files on all Flagler County Health Department providers.
• Assists Fiscal Assistant I (FA1).
• Runs appropriate HMS system reports including the Unbilled report.
• Generates Bill File Creation, which produces the Medicaid Billing File in the absence of other staff.
• Verifies and updates client’s demographics as needed.
• Inputs charges and payments for private paying client services in CHD HMS system.
• Performs additional duties as requested by supervisor.

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