What are the responsibilities and job description for the Senior Financial Operations & Oversight Specialist position at the Franklin County Board of Developmental Disabilities?
Duties & Responsibilities:
Manages all electronic billing from contract providers. Trains new providers and approves provider demonstration file formats. Electronically processes claims to allow payment of eligible claims and rejection of non eligible claims. Returns information about paid and rejected claims to the provider via electronic formats.
Manages the billing of ICF residential providers for adult services provided to their ICF residents by FCBDD’s direct service provider partners. Oversees FCBDD’s participation in the DODD and ODM programs of Patient Liability and Medicaid Buy In. For Patient Liability, oversees the full compliance by Waiver providers in reducing their Waiver billing equal to their billing to FCBDD. For both Patient Liability and Medicaid Buy In, ensures that the Patient Liability amounts and the Medicaid Buy In premiums are computed and assigned correctly and paid timely. Monitors the billings against Waiver authorizations of IO Waiver Providers for all IO services for which consistent billing is expected.
Downloads various DODD Data Warehouse reports and structures the captured data to allow it to be accessed by FCBDD Power BI utilization reports. Routinely monitors electronic billing submissions by LPS, HSC, and County Funded Therapy providers and by FCBDD Early Intervention staff for irregularities.
Provides the Director of Administrative and Support Services the necessary aggregation of electronic data from various sources required to complete the annual County Board Cost Report and documents that aggregated data for later review by Auditor of State Cost Report Auditors.
Performs other related duties as assigned.