DISTINGUISHING FEATURES OF THE CLASS: This is moderately difficult clerical work involved in medical billing, and includes responsibility for performing and/or supervising a variety of medical insurance and related financial record keeping duties. The work may require a general understanding of specific laws related to medical insurance billing, office rules, procedures and policies, and may be performed on an alpha/numeric keyboard. However, employees in this position do not perform double entry bookkeeping. Employees generally follow a prescribed routine and in most cases receive only infrequent general instructions. For the most part, work is performed under general supervision. Supervision may be exercised over the work of one or more clerical assistants. Does related work, as required.
TYPICAL WORK ACTIVITIES:
Oversees and classifies a variety of receipts and expenditures, and distributes items according to prescribed procedures;
Assigns work, reviews and records work done, and instructs new employees in specialized medical insurance billing and related record keeping activities;
Has charge of entering information regarding medical billing in a prescribed manner;
Reviews and checks financial records and reports for arithmetical and clerical accuracy, completeness and proper extension;
Supervises the verifying and accuracy of individual medical insurance billing records/balances;
May supervise and prepare labor, material and operational cost records and reports;
Supervises the processing, sorting, indexing, recording and filing of a variety of control records and reports;
Operates computing, calculating, check writing and other office machines;
Is responsible for the preparation of reports based upon medical billing activities;
Working from rough draft or from data personally developed, types a variety of financial records/reports, payrolls, statistical tabulations and data, form letters, memoranda, vouchers, other reports, requisitions, and materials;
Conducts routine correspondence on matters where policies and procedures are well defined;
Answers telephone and gives out routine information or relieves at switchboard;
Coordinates Medicaid, Medicare and private pay billing;
Maintains financial records related to billing for Medicaid, Medicare, patient billing and third party insurance including HMO’s;
Has responsibility for answering provider questions regarding medical billing procedures and/or problems;
Has direct contact with insurance carriers and employers;
May assess medical cost effectiveness using factors such as pre-existing conditions, prior utilization, cost, and demographics;
Answers family and/or residents questions regarding medical billing issues.
The above examples of duties are intended only as illustrations of the various types of work performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position.
FULL PERFORMANCE KNOWLEDGES, SKILLS, ABILITIES, AND/OR PERSONAL CHARACTERISTICS: Good knowledge of the provisions of standard insurance policies and the applications thereof; good knowledge of modern methods used in maintaining medical
insurance financial records and reports and medical billing procedures; good knowledge of office terminology, procedures and equipment; good knowledge of business arithmetic and English; good knowledge of Medicaid/Medicare; ability to use alpha/numeric keyboard accurately at a satisfactory rate of speed; ability to plan and supervise the work of others; ability to make arithmetic computations rapidly and accurately; ability to write legibly; ability to get along well with others; mental alertness; high degree of accuracy; neatness; tact and courtesy.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to sit, use hands to finger, handle, or feel objects, tools, or controls; and reach with hands and arms. The employee is occasionally required to walk, talk or hear. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually quiet.
MINIMUM QUALIFICATIONS: Graduation from high school or possession of an appropriate equivalency diploma recognized by the NYS Department of Education, including or supplemented by a course or experience in typing, AND:
- Possession of an Associate’s Degree, with a major in accounting, business, math, or related field, AND one (1) year of full-time, paid experience in financial record keeping duties, six (6) months of which shall have dealt with the processing of medical insurance accounts;
OR: - Satisfactory completion of a minimum of 60 semester credit hours in a regionally accredited or New York State registered college or university with at least 18 credit hours in accounting, business, math, or related field, AND one (1) year of full-time, paid experience in financial records keeping duties, six (6) months of which shall have dealt with the processing of medical insurance accounts;
OR: - Three (3) years of full-time, paid experience in financial record keeping duties, one (1) year of which shall have dealt with the processing of medical insurance accounts.
PART-TIME, PAID EXPERIENCE WILL BE PRO-RATED AS APPROPRIATE.