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Rochester

    client account representative - Rochester, United States - Catholic Charities Family Community Services

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    Description

    CLIENT ACCOUNT REPRESENTATIVE
    Job Details

    Job Location

    87 North Clinton Ave - Rochester, NY

    Position Type

    Full Time

    Education Level

    High School Diploma or GED

    Job Shift

    Day

    Description

    General Description

    Under supervision, processes and bills medical and rent charges. Works claim denials and outstanding Invoices for all Medicaid, MCO, Commercial and County payers for agency programs.

    Effectively supports ongoing and collaborative communication amongst all program staff, and is responsible for ensuring a trauma informed care environment.


    Starting Rate:
    $22.00 / hour

    Essential Duties and Responsibilities

    Bills medical claims for all Medicaid, MCO and Commercial Insurance payers for all assigned programs.

    Creates charges in billing system on a daily basis

    Reviews Responsible Party charges for verification of insurance and makes corrections as needed

    Requests authorizations for outpatient services when required by payer


    Reviews and corrects any front-end billing edits prior to submitting claim batches to clearinghouse by working directly with billing support when needed.

    Batches claims and uploads to clearinghouse or directly to payer


    Reviews, corrects and resubmits any clearinghouse or insurance claim rejection error messages by working directly with clearinghouse or billing support when needed.

    Completes paper claim forms (UB- 04 and HCFA1500) and mails directly to payer when needed

    Troubleshoots billing issues when necessary

    Works Denials for all Medicaid, MCO and commercial payers for all assigned programs.

    Works and resolves daily denials received from all payers

    Follows up on outstanding accounts receivables for all payers

    Processes all refunds and claim adjustments requests received by compliance

    Submits refunds to payers in a timely manner to resolve credit balances

    Ensures the claims and denials are followed up on in a timely manner to ensure collection of payment

    Utilizes claims management to track and report on claim status and to ensure a timely follow-up process is followed

    Performs adjustments and write offs to client accounts for all assigned programs.

    Requests appropriate approval prior to processing any write offs


    Adheres to all applicable federal and state laws, including but not limited to those governing client confidentiality, privacy, program standards and billing and documentation standards.

    Has knowledge of federal and state standards governing program documentation and Medicaid and Medicare billing standards and completion of all required service documentation in accordance with such standards

    Maintains up-to-date professional knowledge through reading, workshops/trainings and conferences, as appropriate

    Participates in relevant Agency meetings and/or trainings


    Actively pursues development of professional competencies related to job role performance through reading, supervision, in-service training and attendance at conferences and workshops.

    Awareness and active support of the Agency's Mission, Vision, Values and Strategic Plan. Including, but not limited to, supporting the Agency's Core Competency initiatives of being Collaborative and Community Focused, Innovative and Entrepreneurial, and Culturally Competent and Diverse

    Other duties as assigned

    Note:
    The above description is illustrative of tasks and responsibilities. It is not meant to be all inclusive. Employees are required to follow appropriate supervisory direction and perform other related duties as required.

    Qualifications

    Qualifications

    Education:
    Associates degree in Business Administration or Accounting or equivalent combination of education and experience.

    Experience:
    At least 1 year accounting or client billing experience required, preferably in a non-profit setting.

    Physical Demands/Work Environment:

    The physical demands/work environment 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, talk, hear, stand, walk, use hands to type and/or perform light lifting.

    Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus.
    The noise level in the work environment is usually quiet.

    Compliance:

    Adheres to all applicable federal and state laws and regulations including, but not limited to, those governing confidentiality, privacy, program, billing and documentation standards.

    All duties must be performed in accordance with CCFCS's corporate compliance & ethics program.

    Ability to prioritize assignments, plan, and complete work projects with minimal direction,

    An ability to work efficiently and effectively and meet deadlines,

    An ability to work under pressure,

    Excellent verbal/written skills,

    Ability to maintain confidentiality,

    Ability to demonstrate behaviors and attitudes which support agency mission, philosophy, and policies.

    Willingness and ability to foster agency and program wide cooperation and teamwork through use of positive/constructive communication techniques,

    Possession of a valid NYS Driver's license and use of a registered and reliable vehicle.


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