Position Summary:

Person in this position will oversee the accounts payable and receivable billing functions by managing client accounts, creating billing, and documenting collections while ensuring accuracy according to regulatory standards and in compliance with Illinois Medicaid, Illinois Department of Human Services (IDHS) Substance Use and Prevention (SUPR), and insurance contracts.

Essential Job Functions:

• Create billing claims, including medical coding, claims submissions to grantors (including IDHS SUPR online claims coding and posting), payment posting, accounts receivable follow-up, accounts payable management, and reimbursement management.
• Ensure completion of billing process is performed accurately, effectively, and efficiently within timely filing limits for each payer. Review the documented reasons for payment denials that cannot be re-billed and communicate this to the Financial Operations Manager.
• Contribute to the overall functions of the department to ensure maximization of cash flow.
• Monitor documentation of clinical staff for reimbursement to ensure quality assurance standards are met. Report discrepancies to Financial Operations Manager. Ensure timely feedback to clinical management regarding billing issues and provide direction to remedy or mitigate any identified issues.
• Contribute to development of quarterly and annual reports for grants, agreements, and contracts.
• Supports grant compliance requirements for individual grant budgets, re-budgeting requests, accounting procedures, reporting procedures, file retention, and other government regulations.
• Assist in coordinating annual Medicaid training certification for all applicable staff.
• Embrace and embody the mission, vision, guiding principles, clinical vision, and goals of WestCare Foundation.
• Perform any other duties as assigned.

Essential Qualifications:

• Understanding and implementing applicable billing requirements that can differ across payers on a contract-by-contract basis is a must.

Certifications/Licenses:

• Obtain annual Medicaid training certification.

Education:

• Associate degree in health administration, business administration, or related field is preferred; High school diploma or equivalent is required.

Experience and Competencies:

• Two-plus years of billing experience (grant and insurance preferred)

• Knowledge of medical terminology, CPT, ICD-10, and HCPCS codes
• Must be highly organized, detail focused, and have excellent time management
• Must possess extremely strong computer skills, including advanced Microsoft Excel
• Excellent communication and interpersonal skills, both in person and over the phone
• Ability to pass background check
• Ability to obtain and maintain OIG LEIE clearance
• Ability to pass pre-employment drug screening
• Ability to exercise good judgment and discretion
• Ability to work well in a team environment
• Ability to work under minimum supervision
• Adherence to the highest standard of ethical conduct, especially to standards governing confidentiality
• Must have professional appearance and demeanor
• Must be culturally/linguistically sensitive to populations served
• Ability to obtain and maintain CPR certification, first aid certification, and an annual tuberculosis test

Working Conditions:

• Work is primarily performed in a professional setting.
• There may be periodic travel: local and regional.

Essential Physical and Mental Demands of the Job

The employee must be able to perform the following essential duties and activities with or without accommodation:

Physical Demands:

• Requires mobility and physical activity: Having an adequate range of body motion and mobility to work in an office, residential, or outdoor environment including standing and walking (even and uneven surfaces), sitting for extended periods of time, bending, twisting, reaching, balancing, occasional lifting and carrying of up to 50 pounds. Use of computer and telephone systems is required, which includes coordination of eye and hand, and fine manipulation by the hands (typing, writing, and working with files).

Requires the ability to defend oneself and clients in physically abusive situations through the use of approved verbal de-escalation techniques.

• Requires talking: Expressing or exchanging ideas by means of the spoken word. Talking is required to impart oral information to employees, clients, patients, and the public, and in those activities in which the employee is required to convey detailed or important spoken instructions to others accurately, loudly, or quickly.
• Requires hearing: Hearing is required to receive and communicate detailed information through oral communication.
• Requires seeing: Clarity of vision at 20 inches or less and at distance. This factor is required to complete paperwork for many of the employee's essential job functions and to observe client behavior and activities in and out of the facility.
• The normal work routine involves no exposure to human blood, body fluids or tissues. However, exposure or potential exposure may be required as a condition of employment. Appropriate personal protective equipment will be readily available to every employee.

Mental Demands:

• Requires the ability to collect and analyze complex numerical and written data and verbal information to reach logical conclusions.
• Requires the ability to work and cooperate with clients, co-workers, managers, the public and employees at all levels in order to exchange ideas, information, instructions and opinions.
• Requires the ability to work under stress and in emotionally charged settings.
• The ability to defend oneself and clients in mentally/verbally abusive situations through the use of approved mental/verbal de-escalation techniques.