Job description

POSITION SUMMARY

Under the supervision of the Fiscal and Clerical Services Manager, the Fiscal Specialist performs a variety of detailed billing, collection, fiscal, and clerical duties for all units within Department of Health & Human Services (DHHS), but more specifically the Behavioral Health Unit (BH). Requires the ability to work independently, carry out job duties and responsibilities by utilizing independent judgment skills, multi-task and deliver high quality customer service to both internal and external employees and clients. Essential duties and responsibilities are to be carried out timely and accurately, in accordance with all audit guidelines, State/County/Federal contract and audit requirements, DHHS policies & procedures, and Jackson County ordinances and policies.

Examples of Duties / Knowledge & Skills
ESSENTIAL DUTIES AND RESPONSIBILITIES

• Performs varied billing and collection tasks in accordance with CMS guidance, Western Region of Integrated Care (WRIC) Policies & Procedures, DHHS Billing and Collections Policies and Procedures, Chapter 1 DHS: Uniform Fee Schedule, and all other applicable billing and collections guidance
• Translates client information into alphanumeric medical code
• Verify that correct ICD-10 diagnostic codes, CPT medical billing codes, HCPCS billing and codes, and all other billing codes are assigned appropriately
• Researches and recovers funds paid on behalf of clients who have additionally received retro-active Medical Assistance
• Perform month-end procedures with multiple billing software: processing for a period, and submission and resubmission of claims creating batches, working with held claims, claims for group services, voids and adjustments
• Assists independent and state auditors with departmental audits
• Assists Fiscal and Clerical Services Manager with preparation of WIMCR reporting
• Reviews records for accuracy to identify and correct errors
• Submits claims to Medical Assistance (MA), Wisconsin Physician Service (WPS) and private insurance for case management and other services provided by BH or contract providers
• Reviews payments received, remittance advices and other documents to prepare Accounts Receivable breakdown
• Investigate all unpaid claims
• Assist in credentialing and maintaining new insurance companies in the billing software systems including medical coding and rate information
• Provide problem resolution related to billing processes
• Answers questions regarding financial interview process, accounts, collection procedures, HMO health insurance plans, etc.
• Communicates with contracted collection agency on client accounts and ensures accounts are in compliance with Statute of Limitations
• Ensure appropriate prior authorizations are obtained as necessary, are properly documented in billing software systems and resolve associated problems
• Research and communicate Forward Health eligibility with DHHS staff
• Research and calculate co-pays and deductible that are applicable and alert the BH front desk that collection of money is needed for scheduled clients
• Communicate with various DHHS staff to clarify billing documentation requirements
• Send collection letters to clients not making payments on services received
• Monitor client closings to ensure documentation and billing processes were completed correctly and back-bill as needed
• Prepares and sends client statements monthly
• Ensures invoices sent to clients, providers and other agencies are paid timely
• Prepares accounts eligible for write-off on annual basis
• Prepares payment authorizations to include appropriate funding account(s), categories, and other required data as needed for approval
• Forwards invoices and other payment detail to respective DHHS staff for program compliance and quality assurance purposes
• Ensures compliance with payment and service authorization process by reviewing for accuracy; identifying, correcting, and documenting errors; and ensuring proper documentation is attached before processing
• Reviews and links client, vendor and contract data found on financial documents into electronic system for BH.
• Reviews and processes invoices for BH
• Researches and follows up on inquiries from vendors regarding late/missing payments for BH
• Organizes and files all documentation accurately
• Reviews daily and weekly A/R log from BH front desk and verifies that they have been coded to appropriate funding accounts, communicating potential issues, and inputs account numbers next to each transaction for BH.
• Partners with Fiscal Analyst and Contract Administrator regarding A/R log reconciliation process
• Enters all accounts receivable data into electronic system weekly for BH.
• Ensures accounts receivable batches are posted weekly at DHHS and at County Treasurer's office, communicating with County Treasurer personnel as needed
• Inspects all contents of BH front desk safe weekly to ensure accurate and timely deposits are conducted
• Processes NSF transactions
• Collaborates and partners with all DHHS managers and employees to gain necessary knowledge on programmatic and fiscal detail
• Assists in preparing DHHS policies and procedures
• Teach and train DHHS staff in regards to financial processes
• Assist Fiscal and Clerical Services Manager in updating and maintaining Jackson County DHHS Fee Schedule
• Attends monthly Business Services staff meetings and other meetings as requested
• Provides information to management and staff on financial activities and records
• Maintains security and confidentiality of records
• Performs general agency typing of letters, memos and forms
• Performs back-up and other duties within department as needed and assigned by the Fiscal and Clerical Services Manager

Minimum qualifications & Requirements
EDUCATION AND EXPERIENCE REQUIREMENTS

• Associate degree or equivalent in Medical Billing, Business Administration, Accounting, or related field preferred
• Minimum of one (1) year experience in an accounting or billing position
• Experience in Medical Assistance and private insurance billing preferred
• A combination of education and experience may be considered

Supplemental information
SUPERVISORY RESPONSIBILITIES

None

KNOWLEDGE, SKILLS AND ABILITIES REQUIREMENT TO PERFORM JOB

• Knowledge of Microsoft Office Suite programs
• Knowledge of agency programs and operations
• Knowledge of policy and procedure related to general functions performed
• Ability to plan, organize, and prioritize work
• Ability to work with confidential material
• Ability to multi-task
• Ability to read and interpret documents, and laws in the English language
• Ability to listen to and understand information and ideas in spoken and written format so individuals may effectively understand and convey communications
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
• Ability to compute rate, ratio, and percent
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form
• Inductive and deductive reasoning – ability to combine separate pieces of information, or specific answers to problems, to form general rules or conclusions; includes coming up with a logical explanation for why a series of seemingly unrelated events occur together and deciding if an answer makes sense

CERTIFICATES, LICENSES, REGISTRATIONS

• Possess and maintain valid Wisconsin Driver's license and have access to transportation suitable to complete necessary work out of the office

HIPAA RESPONSIBILITY

All members of the workforce have a responsibility to watch for unauthorized use or disclosures of Protected Health Information (PHI), to act to prevent the action, and to report suspected breaches of privacy and security policies to their supervisor, or to the Privacy or Security Officer (example of a breach: member or visitor looking through a claim or personal information left on a desk).

PHYSICAL DEMANDS

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. The employee is regularly required to stand, walk, use hands to finger, handle or feel objects; reach with hands and arms, hear and talk. The employee may be required to run, sit, stoop, kneel, crouch, crawl, climb, balance, taste and smell. May seldom be required to lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

BENEFIT SUMMARY:

Health Insurance Employee Contribution 2023:
Plan 1 - Quartz HMO:
Premium Employee Share - 11%
Family - $1,842.09/month $ 202.63/month
Single - $ 808.11/month $ 88.90/month

SHERIFF'S DEPUTIES UNION:
Premium Employee Share - 12%
Family - $1,842.09/month $221.05/month
Single - $ 808.11/month $ 96.98/month

Plan 2 - Quartz HSA:
Premium Employee Share
Family - $1,640.92/month $147.69/month
Single - $ 655.07/month $ 64.79/month

SHERIFF'S DEPUTIES UNION:
Premium Employee Share
Family - $1,640.92/month $196.91/month
Single - $ 633.47/month $ 86.39/month

Vision - VSP 2023
Family - $22.44
Employee + 1 - $13.63
Employee & Children - $13.92
Single Plan - $7.66

Dental Insurance 2023: Employee Share – 50%
Premium Employee Share
Family Plan - $71.36/month $35.68/month
Single Plan - $25.04/month $12.52/month

Life Insurance: County paid for employee equal to yearly salary. Additional coverage and coverage for spouse and dependents are available at additional cost.

Deferred Compensation Plans: Two plans are available.

Voluntary Accident/Cancer/Critical Illness Insurance: Employer will contribute $10 per month towards the plan.

ID Protection

State Retirement: Employer match 50%

Sick Leave: 1 day per month - accumulating

Vacation: General Employees: 10 days during years 1 & 2 to a maximum of 25 days after 21+ years
Managers: 15 days per year during 1st – 6th years of service; to a maximum of 25 days
Jail/Dispatch: 12 days during years 1-5 to a maximum of 25 days after 21+ years

Holidays: Non-Law Enforcement: 9 specific and 1 floating
Law Enforcement: 10 personal days in lieu of holidays

This benefit summary is for informational purposes only. It is not intended as an implied contract of employment.

Job Type: Full-time

Pay: $19.15 - $21.88 per hour

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