What are the responsibilities and job description for the Administrative Coordinator I / DOFS / OP Reimbursement position at State of South Carolina?
JOB
With our Agency's mission to support the recovery of people with mental illnesses, we provide a complete array of medical and support services for children, adults, and families throughout South Carolina. This position is located at the Department of Mental Health, Central Office, 2414 Bull Street, Columbia, SC 29201.As the Administrative Coordinator I, you will process claims for Community Mental Health Centers. Ensures all electronic claims for billing are filed in a timely and accurate manner. Responsible for resolving outstanding claims, insurance verification, enters and reconciles billing, and transfers to other TPL as necessary. Follow up on claims filed and ensures payment is received by insurance carriers. Ensures billing reports are completed with accuracy. Responds to correspondence through mail or telephone as needed.Responsibilities include but are not limited to: Creates TPL claims once charges are closed and accurately allocated. Prepares and batch all claims in the CIS system for transmission and processing into clearinghouse. Must process claims, work errors and rejections accordingly in clearinghouse for CMHC.Performs appropriate follow up activities to ensure timely and accurate reimbursement and to minimize aged claims. Maintains files to document all work related to claims processing follow up actions and/or denials. Contacts any TPL carrier or utilize poral access to obtain and/or verify any available benefits or coverage information for CMHC.Post and balance any payments received manually or electronically. Also works monthly recon report from AR Department.Completes weekly and monthly reports to include but not limited to outstanding, unbilled, error, and balancing reports, etc.Works with center billing staff to complete necessary correspondence, reporting, billing corrections, credit card posting, etc., as needed.Responds to any correspondence and telephone calls for sources within a timely manner.
EXAMPLE OF DUTIES
State Minimum Requirements: A high school diploma and relevant experience in business management, public administration, or administrative services or a bachelor's degree may be substituted for the required work experience. Agency Minimum Requirements: A high school diploma and three (3) years relevant experience in medical claims processing, professional management, public administration, or administrative services or a bachelor's degree may be substituted for the required work experience.Note: If any Agency Requirements are listed above, applicants must also meet those requirements to be considered for the position.
SUPPLEMENTAL INFORMATION
The selected candidate must be capable of researching medical claims records to obtain accurate accounting of finance, auditing, receipts and other financial transactions. Extensive knowledge of healthcare insurance policies, medical claims forms and billing processes. Possess clear concise, oral and written communication skills. Experience with claims processing software. Must be detailed oriented and understand and carry out accounting balancing procedures.The South Carolina Department of Mental Health is an Equal Employment Opportunity Agency. We provide affirmative action and equal opportunity in employment for all qualified persons regardless of race, color, sex – including the basis of pregnancy, childbirth, or related medical conditions, national origin, age, religion, or disability. South Carolina is making our Veterans a priority for employment in state agencies and institutions. Supplemental questions are considered part of your official application. Any misrepresentation will result in your disqualification from employment. Please complete the state application to include all current and previous work history and education. Please account for any and all gaps of employment in your application. A resume will not be accepted in lieu of application completion nor reviewed to determine if an applicant has met the qualifications for the position. The South Carolina Department of Mental Health offers an exceptional benefits package for FTE positions that includes: Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children15 days annual (vacation) leave accrual per year15 days sick leave per year13 paid holidaysState Retirement Plan and Deferred Compensation Programs
With our Agency's mission to support the recovery of people with mental illnesses, we provide a complete array of medical and support services for children, adults, and families throughout South Carolina. This position is located at the Department of Mental Health, Central Office, 2414 Bull Street, Columbia, SC 29201.As the Administrative Coordinator I, you will process claims for Community Mental Health Centers. Ensures all electronic claims for billing are filed in a timely and accurate manner. Responsible for resolving outstanding claims, insurance verification, enters and reconciles billing, and transfers to other TPL as necessary. Follow up on claims filed and ensures payment is received by insurance carriers. Ensures billing reports are completed with accuracy. Responds to correspondence through mail or telephone as needed.Responsibilities include but are not limited to: Creates TPL claims once charges are closed and accurately allocated. Prepares and batch all claims in the CIS system for transmission and processing into clearinghouse. Must process claims, work errors and rejections accordingly in clearinghouse for CMHC.Performs appropriate follow up activities to ensure timely and accurate reimbursement and to minimize aged claims. Maintains files to document all work related to claims processing follow up actions and/or denials. Contacts any TPL carrier or utilize poral access to obtain and/or verify any available benefits or coverage information for CMHC.Post and balance any payments received manually or electronically. Also works monthly recon report from AR Department.Completes weekly and monthly reports to include but not limited to outstanding, unbilled, error, and balancing reports, etc.Works with center billing staff to complete necessary correspondence, reporting, billing corrections, credit card posting, etc., as needed.Responds to any correspondence and telephone calls for sources within a timely manner.
EXAMPLE OF DUTIES
State Minimum Requirements: A high school diploma and relevant experience in business management, public administration, or administrative services or a bachelor's degree may be substituted for the required work experience. Agency Minimum Requirements: A high school diploma and three (3) years relevant experience in medical claims processing, professional management, public administration, or administrative services or a bachelor's degree may be substituted for the required work experience.Note: If any Agency Requirements are listed above, applicants must also meet those requirements to be considered for the position.
SUPPLEMENTAL INFORMATION
The selected candidate must be capable of researching medical claims records to obtain accurate accounting of finance, auditing, receipts and other financial transactions. Extensive knowledge of healthcare insurance policies, medical claims forms and billing processes. Possess clear concise, oral and written communication skills. Experience with claims processing software. Must be detailed oriented and understand and carry out accounting balancing procedures.The South Carolina Department of Mental Health is an Equal Employment Opportunity Agency. We provide affirmative action and equal opportunity in employment for all qualified persons regardless of race, color, sex – including the basis of pregnancy, childbirth, or related medical conditions, national origin, age, religion, or disability. South Carolina is making our Veterans a priority for employment in state agencies and institutions. Supplemental questions are considered part of your official application. Any misrepresentation will result in your disqualification from employment. Please complete the state application to include all current and previous work history and education. Please account for any and all gaps of employment in your application. A resume will not be accepted in lieu of application completion nor reviewed to determine if an applicant has met the qualifications for the position. The South Carolina Department of Mental Health offers an exceptional benefits package for FTE positions that includes: Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children15 days annual (vacation) leave accrual per year15 days sick leave per year13 paid holidaysState Retirement Plan and Deferred Compensation Programs
