What are the responsibilities and job description for the PATIENT RELATIONS REPRESENTATIVE IV-HEALTH DEPARTMENT position at Bladen County?
JOB
An employee in this classification performs routine to moderately complex accounting and clerical work involved in the billing of monies due the Bladen County Health Department for services provided through the Community Alternatives Program (CAP) with contingency of billing for other departments within the Bladen County Health Department. Prepares related records and reports. Work is performed under general supervision and is evaluated on the basis of attainment of individual performance objectives, observation and accuracy of work.
EXAMPLE OF DUTIES
Submits billing for services provided to Medicaid, Medicare, private insurances, contract accounts and self-pay patients; keys charges in paper and electronic form provided by the clinical staff and the CAP case managers and R.N.'s; ensures the billing is transmitted timely and paid accurately; follows up denials of claims and resubmits corrections to said insurances.Researches and resolves denied claims; researches the denial reason by completion of all or some of the following: reviews client chart to assure all information is correct, contacts the Income Maintenance Caseworker at DSS to assure no problems with CAP indicators or eligibility in system, refiles claim based on findings, consults with case manager or supervisor for assistance, consults with representatives at NC TRACKS and all other insurance agencies to facilitate claims processing; reviews patient chart information in the electronic medical record system (CureMd) to ensure information is accurate to successfully complete billing in a timely manner.Pulls financial records, as requested, for patients and accepts payments from clients; accepts payment and provides client with a receipt showing paid amount and balance; records payments in the patients’ electronic medical record; records payments in a paper journal and turns payments into the Administrative Officer or their designee at the end of each business day. Assures responsibility for development of an accounting record on each individual client to track any losses in reported revenue; advises the CAP Supervisor if case managers do not meet monthly Case Management quotas following receipt of vouchers or if billing efforts are delayed by the actions of a case manager; keeps a monthly log of visits billed per patient per case manager, supplies billed and paid, and revenue totals; gives reports to each case manager and CAP Supervisor at the end of the month. Sends patient statements quarterly; inspects statements to ensure statements are not sent inappropriately or with errors. Operates the front desk when staff is minimal; enters patient information into the electronic medical record, adds insurance information, and makes copies of all authorizations for front desk to scan into the patients’ electronic record; makes outside mail distribution and collection, transports medical records to the hospital and delivers revenue to the Finance Office when the front desk staff cannot administer these duties. Ensures transmittal of monthly batching records from the EMR System, CureMd, to the state recording office, HIS; prints a BL201, a batch county error report, from the HIS electronic system, Avatar, and fixes all electronic medical errors and resubmits to HIS, using the directions set by the HIS and CureMd personnel.Attends professional seminars and classes in relation to billing procedures, technical support and skills needed to provide continued staff support. Greets the public courteously and professionally as they enter the office or attends to their phone calls; Provides basic information regarding CAP and Bladen County Health Department services.Maintains all billing records on current and former patients for the Bladen County Health Department and CAP office.Position will be responsible for other duties as assigned. Duties may also include Preparedness activities/directives as assigned by Supervisor, Nursing Director or Agency Director.
SUPPLEMENTAL INFORMATION
Graduation from high school and demonstrated possession of knowledge, skills, and abilities gained from at least two years of office assistant/ secretarial/processing assistant experience, or an equivalent combination of training and experience. Special RequirementsPossess valid North Carolina Driver’s LicenseFLSA Status: Non-Exempt DisclaimerThis classification specification has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to perform the job. Bladen County reserves the right to assign or otherwise modify the duties assigned to this classification.December 2017BLADEN COUNTY IS AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
An employee in this classification performs routine to moderately complex accounting and clerical work involved in the billing of monies due the Bladen County Health Department for services provided through the Community Alternatives Program (CAP) with contingency of billing for other departments within the Bladen County Health Department. Prepares related records and reports. Work is performed under general supervision and is evaluated on the basis of attainment of individual performance objectives, observation and accuracy of work.
EXAMPLE OF DUTIES
Submits billing for services provided to Medicaid, Medicare, private insurances, contract accounts and self-pay patients; keys charges in paper and electronic form provided by the clinical staff and the CAP case managers and R.N.'s; ensures the billing is transmitted timely and paid accurately; follows up denials of claims and resubmits corrections to said insurances.Researches and resolves denied claims; researches the denial reason by completion of all or some of the following: reviews client chart to assure all information is correct, contacts the Income Maintenance Caseworker at DSS to assure no problems with CAP indicators or eligibility in system, refiles claim based on findings, consults with case manager or supervisor for assistance, consults with representatives at NC TRACKS and all other insurance agencies to facilitate claims processing; reviews patient chart information in the electronic medical record system (CureMd) to ensure information is accurate to successfully complete billing in a timely manner.Pulls financial records, as requested, for patients and accepts payments from clients; accepts payment and provides client with a receipt showing paid amount and balance; records payments in the patients’ electronic medical record; records payments in a paper journal and turns payments into the Administrative Officer or their designee at the end of each business day. Assures responsibility for development of an accounting record on each individual client to track any losses in reported revenue; advises the CAP Supervisor if case managers do not meet monthly Case Management quotas following receipt of vouchers or if billing efforts are delayed by the actions of a case manager; keeps a monthly log of visits billed per patient per case manager, supplies billed and paid, and revenue totals; gives reports to each case manager and CAP Supervisor at the end of the month. Sends patient statements quarterly; inspects statements to ensure statements are not sent inappropriately or with errors. Operates the front desk when staff is minimal; enters patient information into the electronic medical record, adds insurance information, and makes copies of all authorizations for front desk to scan into the patients’ electronic record; makes outside mail distribution and collection, transports medical records to the hospital and delivers revenue to the Finance Office when the front desk staff cannot administer these duties. Ensures transmittal of monthly batching records from the EMR System, CureMd, to the state recording office, HIS; prints a BL201, a batch county error report, from the HIS electronic system, Avatar, and fixes all electronic medical errors and resubmits to HIS, using the directions set by the HIS and CureMd personnel.Attends professional seminars and classes in relation to billing procedures, technical support and skills needed to provide continued staff support. Greets the public courteously and professionally as they enter the office or attends to their phone calls; Provides basic information regarding CAP and Bladen County Health Department services.Maintains all billing records on current and former patients for the Bladen County Health Department and CAP office.Position will be responsible for other duties as assigned. Duties may also include Preparedness activities/directives as assigned by Supervisor, Nursing Director or Agency Director.
SUPPLEMENTAL INFORMATION
Graduation from high school and demonstrated possession of knowledge, skills, and abilities gained from at least two years of office assistant/ secretarial/processing assistant experience, or an equivalent combination of training and experience. Special RequirementsPossess valid North Carolina Driver’s LicenseFLSA Status: Non-Exempt DisclaimerThis classification specification has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to perform the job. Bladen County reserves the right to assign or otherwise modify the duties assigned to this classification.December 2017BLADEN COUNTY IS AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
