CLASSIFICATION DETAILS
DEPARTMENT: Community Mental Health
HIRING AUTHORITY: Chief Executive Officer
FLSA STATUS: Non-exempt
EMPLOYMENT RELATIONSHIP: Just cause subject to probationary period
CURRENT HOURS AND STARTING TIME: Full-time (37.5 hours per week) position. The current starting time for this position is 8:30 a.m. Weekend and evening hours are required for this position.
Under direction, provides support to the Finance and Budget division of Community Mental Health. Oversees the billing and reimbursement activities within the Finance and Budget divisions. Ensures billing and revenue collection duties are completed timely and accurately. Develops revenue projections for use in fiscal reporting; performs related duties as assigned.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Provides support to the CMH Finance and Budget divisions in all areas of reimbursement and billing.
Ensures billing and revenue collection duties are completed timely and accurately.
Develops regular data reports related to billing and reimbursement; analyzes trends and identifies problems.
Utilizes computer software system to perform billing and reimbursement duties.
Establishes new records in the FOCUS system to support new billing processes as needed.
Develops mechanisms to ensure that client financial data in the software system is accurate.
Assists CMH staff and contract agencies in following proper billing practices for securing Medicaid and other benefits.
Works closely with the Department of Human Services to assist staff in enrolling consumers in Medicaid, Supplemental Security Income and obtaining other benefits.
Provides technical assistance to direct staff and PIHP contract agencies with billing and reimbursement issues.
Provides direction and training to direct staff and PIHP contract agencies on billing and reimbursement issues.
QUALIFICATIONS
Required Education and Experience
- Bachelor’s Degree in Accounting, Business Administration, Finance or a directly related field from an accredited college or university
- Five (5) years of experience with a Community Mental Health Services Program (CMHSP) or Prepaid Inpatient Health Plan (PIHP)
- Two (2) or more years of experience working with Quality Improvement processes and techniques
Preferred Education and Experience
- Experience with an electronic medical record system from Peter Chang Enterprises (PCE)
Required Licenses or Certifications
- Professional Certified Medical Coder
- Possession of a valid Michigan driver’s license and operable, insured automobile for authorized travel
Preferred Licenses or Certifications
COMPETENCIES FOR SUCCESSFUL PERFORMANCE OF JOB DUTIES
Knowledge of:
- Knowledge of applicable computer applications.
- Knowledge of billing practices for Medicaid, Healthy Michigan, MIHealth Link and other funding sources.
- Knowledge of third-party insurance procedures and requirements.
- Knowledge of Medicare insurance procedures and requirements.
- Thorough understanding of the American Physicians Association CPT AND HCPC code definitions and uses.
- Knowledge of Michigan Mental Health Code and provided services.
- Knowledge of financial information on patient resources.
- Knowledge of credit collection laws and procedures.
- Knowledge of what constitutes legal liability.
Skill in:
- Using good professional judgement and initiative.
Ability to:
- Collaborative: Approaches all situations with a teamwork and solution focused mindset demonstrated through active participation in meetings, volunteering to assist teammates and other departments as appropriate. Examples include participation in internal and external committees, subcommittees, process improvement groups or other multi-organizational initiatives
- Accountable: Takes ownership and empowers others to do the same as evidenced by identifying solutions and acting on job responsibilities and organizational objectives, daily
- Respectful: Treats people with dignity while honoring individual differences demonstrated through use of positive and encouraging statements and/or interactions to, about and/or with colleagues and persons served; evidenced by supervisor observation, feedback from other department staff and leadership
- Work in environment which embraces the county’s Dignity Campaign
- Effectively speak, write, and understand the English
- Effectively speak, write, and understand a language other than English is preferred
- Understand and carry out oral and/or written instructions
- Accurately organize and maintain paper documents and electronic files
- Maintain the confidentiality of information
- Work independently