Financial Associate II - Billing Specialist

POSITION SUMMARY: 
This position assists the Finance Department in the overall administration and management of the Finance Department functions. Work functions include medical billing, cash handling, and accounts receivable. 
ESSENTIAL FUNCTIONS: 
The following duties are normal for this position. These are not to be construed as exclusive or all-inclusive. To perform this job successfully, an individual must be able to perform each duty satisfactorily. Other duties may be required and assigned. 
The allocation of duties for this position will be dependent upon the assignment of the position.  Duties will be assigned accordingly. 

• Receives invoices from vendors. Review for accuracy and confirm rates match contract amounts. Enters charges into Electronic Health Record (E.H.R)
• Reconciles General Ledger accounts and prepares journal entries.
• Completes financial interviews with consumers either in person or over the phone to gather insurance information, verification of assets and income to determine ability to pay.  Obtain signatures on required paperwork for releases, ABN and billing.
• Verifies insurance benefits and obtains prior authorizations for services. Reviews documentation submitted by staff to ensure accurate completion before submission. Monitors use of services and obtains additional authorizations as they expire, or approved visits are consumed.
• Prepares the daily appointment schedule. Reviews insurance notes and most recent interview date and notes. 
• Bills services to Medicare, Medicaid, Commercial Insurance, and Self Pay. Follows-up on unpaid claims.
• Sorts, balances, and assigns G/L account numbers to cash, checks, credit card and EFT payments received. 
• Completes deposit and provides treasurer and other departments with deposit documentation.  Creates journal entries for recording of deposit to G/L.
• Applies payments to consumer accounts in Electronic Health Record (E.H.R); makes rate adjustments, initiates refund for over payments, disputes incorrect claim payments or denials.
• Communicates with consumers to accept payments, provides explanations regarding account balances, and sets up payment plans on past due accounts.
• Assists consumers with applications for medical assistance and family care.
• Provides Medicare Notices of Non-Coverage to consumers. Assists with appeals and denial process.
• Other duties as assigned. 

KNOWLEDGE, SKILLS AND ABILITIES   
This section details the essential competencies required to perform the job effectively, including a mix of technical knowledge, practical skills, and personal attributes. 

• Knowledge of accounting, budgeting, and auditing principles (including GASB rules and GAAP standards) and methods in their application to a government accounting system.
• Knowledge of governmental accounting methods, procedures, and financial practices.
• Knowledge of County programs, funding sources, and specific regulations governing expenditures and revenues.
• Knowledge of principles, practices, and techniques of public administration, with particular reference to governmental budget and finance administration.
• Ability to prepare and maintain complex and accurate financial documents and reports.
• Understanding of the structure, functions, policies, procedures, and operations of County government, including departmental operations, as well as the broader context of local, state, and federal government agencies, particularly within Wisconsin. 
• Technical proficiency in the use of standard office software applications, databases, and technology tools relevant to the position (e.g., Microsoft Office, Outlook, SharePoint, etc.), as well as general knowledge of modern office practices, procedures, and equipment. 
• Strong organizational and time management skills, including the ability to manage multiple priorities, and adjust to changing demands, and meet critical deadlines in a fast-paced environment while maintaining a high degree of accuracy and attention to detail. 
• Ability to type accurately and demonstrate proficiency in word processing, data entry, and the preparation, review, and processing of documentation. 
• Ability to apply ethical judgment and maintain confidentiality and discretion when handling sensitive or protected information, in compliance with open records law and other applicable state and federal statutes and regulations. 
• Ability to interact professionally, respectfully, and tactfully with coworkers, other departments, external agencies, and the public, and work effectively as part of a team.

LANGUAGE SKILLS   
This section outlines the communication abilities necessary for effective performance.  These skills reflect the need to interact with the public, colleagues, and other stakeholders in a clear, professional, and effective manner. 

• Ability to communicate effectively in English, both verbally and in writing, with a wide range of individuals, including the public, colleagues, and supervisors.
• Ability to read, interpret, and apply information from complex documents such as laws, regulations, policies, procedures, and reports.
• Ability to engage with the public, handle inquiries, resolve conflicts, and build positive relationships with a diverse population.

MATHEMATICAL SKILLS 

• Ability to perform mathematical calculations. 
• Ability to reconcile accounts and balance financial transactions.
• Ability to calculate charges, payments, adjustments, and account balances. 
• Ability to comprehend complex financial records for accuracy and completeness. 

REASONING ABILITY 
This section outlines the cognitive skills required to perform the job effectively.  This includes the ability to apply logic, make decisions, solve problems, and understand complex information.  

• Ability to respond to complaints and grievances posed by the public.
• Ability to identify and define problems, collect data, establish facts, and draw valid conclusions.
• Ability to make decisions that are sound, well-informed, and timely, even in stressful situations.
• Ability to analyze situations, consider various perspectives, anticipate potential issues, and make recommendations or decisions based on logical reasoning.
• Ability to interpret complex information, recognize patterns, and understand the implications of actions or decisions.
• Ability to think conceptually and understand the relationships between ideas that are not immediately obvious.

PHYSICAL AND WORK ENVIRONMENT: 
The physical and work environment characteristics described in this description 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 or as otherwise required by law.  Employees needing reasonable accommodation should discuss the request with the employee's supervisor.   
PHYSICAL REQUIREMENTS 

• This work requires occasional exertion of up to 10 pounds of force; work regularly requires sitting, frequently requires standing, using hands to handle, feel, and perform fine motor skills and repetitive motions, and occasionally requires walking, stooping, kneeling, crouching or crawling and reaching with hands and arms overhead or below the waist.
• Sufficient vision to perform tasks such as reading documents, operating vehicles, or working with detailed data.
• Vocal communication is required for expressing or exchanging ideas by means of the spoken word.
• Ability to hear and understand speech at normal levels for tasks such as communicating with the public, colleagues, or over the phone. 
• Work requires preparing and analyzing written or computer data and observing general surroundings and activities.
• Work has no exposure to environmental conditions.
• Work is generally in a moderately noisy location (e.g. business office, light traffic). 

WORK ENVIRONMENT 

• Work is primarily in an office setting.

MINIMUM QUALIFICATIONS:
EDUCATION AND EXPERIENCE REQUIREMENTS 

• Associate's degree in accounting, finance, business management or related field.
• Minimum of two (2) years of experience working in an accounting/bookkeeping position.
• Equivalent combination of education, skills, knowledge, and abilities may be substituted for above listed requirements.
• Appointment will be conditional upon successful completion of a criminal background check.

EXPERIENCE PREFERRED  

• Minimum of two (2) years of experience working in a nursing home, medical or mental health field. 
• Medical claim submission and compliance requirements within CMS (Centers for Medicare & Medicaid Services).