Community Action Committee of Pike County

Position Title:

Billing Specialist

Department:

VVHC Billing

Reports To:

Billing Supervisor

Program Director:

Assistant Executive Director for Finance

FTE:

1.0

FLSA Designation:

Non-exempt

EEOC Category:

Administrative Support Workers

Pay Level:

D1

Effective Date:

01/01/2021

HR Approval:

Employee Signature:

About Community Action Committee of Pike County…

Since 1966, the Community Action Committee of Pike County has been providing a broad base of much needed services to residents of Southern Ohio to promote self-sufficiency and to address the major causes of poverty. We are an embodiment of our nation’s spirit of hope – changing people’s lives and improving the communities we serve.

About CAC Leadership and Program Support…

CAC leadership and program support is comprised of the offices Administration, Fiscal, Human Resources, and Information Technology. Together, these departments play an integral role in helping our programs to live-out the mission, vision, and core values of the Community Action Agency of Pike County – everyday. We provide expertise and assistance with strategic planning, fiscal opportunities and financial management, risk management and compliance, employee relations and performance management, technology and systems solutions, leadership development, and organizational excellence. We strive to be forward-thinking and innovated in our approach to moving the agency forward and to improve the well-being and independence of those we serve.

Position Impact and Purpose…

Responsible for ensuring Valley View Health Center (VVHC) claims are submitted processed, posted and closed in a timely manner. Responsible for ensuring all billing aspects on behalf of the Valley View Health Centers.

www.pikecac.org

OUR MISSION…

It is the mission of the Community Action Committee of Pike County to improve the well-being and independence of those we serve.

OUR VISION…

It is the vision of the Community Action Committee of Pike County to be the leading community service provider and employer of choice in the region.

OUR LOCATIONS…

Piketon

Waverly

Jackson

Portsmouth – Broadway

West Portsmouth

Manchester

OUR PROGRAMS & SERVICES…

• Early Childhood & Head Start

• Energy & Weatherization

• Workforce & Business Development

• Senior Programs

• Community Action Transit System (CATS)

• Social Services

• Pike Mobility Management

• Health Insurance Marketplace Assistance

• Women, Infants, & Children (WIC)

• Free Tax Preparation

• Valley View Health Centers

• Primary Care

• General Dentistry

EQUAL OPPORTUNITY COMMITMENT…

Community Action Committee of Pike County is an equal opportunity employer. No personnel decisions concerning any term or condition of employment shall be based upon race, color, religion, sex, sexual orientation, national origin, ancestry, disability, Vietnam-era status, age, military status, place of birth, or genetic information, except where such criteria constitute a bona fide occupational requirement.

Key Relationships…

• Assistant Executive Director for Finance

• Ohio and Kentucky Department of Medicaid

• Accounts Receivables Specialist

• Financial Manager – Valley View

• Managed Care Companies

• Accounts payable Clerk

• Direct Supervisor

• Financial Administrative Assistant

• Internal Controls

• Insurance companies

• VVHC Providers

Key Characteristics and Competencies…

• Excellent Communicator

• Working knowledge of medical billing procedures

• Accurate

• Familiar with the operation of general office equipment

• Confidential - HIPPA

• EMR and Microsoft Office Products – Computer Skills

• Self-motivated and able to multi-task

• Insurable under agency’s policy

• Great customer service skills

• Organization Skills

• Ability to handle confidential information in a professional manner

• Billing competency testing passed prior to completion of instructional period

• Problem Solving

• Remain calm in times of crisis

• Appropriate dress attire

• Attention to Detail

• Works efficiently in fast paced environment

• Best Billing Practices - FQHC

• Professional

Essential Functions…

Functional Area:

Estimated Effort:98%

Responsibilities, Deliverables, Outcomes and Expectations

• Provide excellent customer service, including but not limited to helping patients understand their billing and charges for which they are responsible, setting up payment arrangements, etc.

• Work directly with insurance companies, providers, and patients to get claims processed and paid

• Responsible for submitting claims electronically through current practice management/clearinghouse. Any claims needing corrections should be completed by the end of the following business day and resubmitted.

• Ensure all claims are submitted in an accurate and timely manner

• Responsible for following up on claim denials and resubmit billing as needed

• Responsible for keeping accurate accounts receivables – accurately logging of payments received from insurance companies and patients while maintaining current records and balances. Monitoring claims, ensuring claims that reach 30 days or older are prioritized and followed up on verifying eligibility and/or re-billing insurance companies.

• Responsible for reconciling remittance advices and scanning EOB’s

• Responsible for employee deductions on a bi-weekly basis

• Assist in preparing documentation for refunds to patients or insurance companies

• Responsible for processing patient statements and mailing accordingly

Functional Area:

Collaboration and Support

Estimated Effort:2%

Responsibilities, Deliverables, Outcomes and Expectations

• Attend meetings, conferences and training sessions related to the duties of this position and disseminate acquired information to appropriate individuals inside and outside of the agency.

• Serves as a representative of the fiscal department on assigned CAC committees.

• Assist in performing task necessary to achieve the organizations mission. Any other duties needed to help drive our vision, fulfill our mission, and abide by the organizations values.

• Serve as a backup for Medical/Dental Patient Access Representatives when needed

Minimum Requirements…

Education:

High School Diploma or equivalent

Job-Related Experience:

• Excellent customer service and phone manner

• Strong attention to detail, organization skills and ability to multitask

• Must have the ability to work independently and prioritize duties

• Capable of accurate data entry skills, most numerical

• Fluent understanding of office equipment- copier, scanner, etc.

• Possess basic skills with Windows, Microsoft Word and Excel

Preferred Qualifications…

Preference given to individuals with FQHC experience or medical billing experience

Working Conditions…

Position is in a well-lighted office environment. This position may require occasional local and regional travel to attend meetings, conferences and training sessions related to duties. Work is fast paced and deadline driven. Can involve low-to-moderate levels of stress.