General Function
Ensures continuous improvement of client care and requisite billing from review of authorizations, client files, and electronic medical record processes, to contract and agency requirements.
All activities of this position are driven by the billing schedules and accounts receivable aging.
Duties and Responsibilities
Completes and monitors completion of authorizations to billing schedule.
Reviews client files, monitors clinical notes conformance, coding and corrections to the billing schedule.
Prepares and maintains process toolsets for reviews, reports and corrections through the revenue cycle.
Reviews/interprets data that is supplied or gathered for accuracy and completeness prior to billing.
Daily monitoring of billing correspondence with staff.
Researches and resolves billing inquiries for programs as assigned.
Proactively seeks opportunities to enhance billing processes.
Work with other departments to ensure correct billing.
Assists with monthly analysis, activity and reporting to prepare accounts for billing.
Works collaboratively with operations to see that clients are served, billing questions are resolved, including assisting with ensuring authorizations are completed on a timely basis.
Other duties as assigned.
Additional Responsibilities
Secures all necessary pre-authorizations and/or authorizations to assure payment for services rendered.
May perform intakes for Outpatient Program as authorized.
Attends and participates in ongoing staff development activities.
Promotes Mid-Michigan Recovery Services Inc.
’s [MMRS Inc.
] philosophy and mission through personal attitudes, actions, and behaviors.
Demonstrates cultural competency and the ability to work effectively with a diverse population.
Strictly adheres to applicable law, regulations, contract and MMRS policy and procedure
Participates in program staff meetings.
Complies with agencies conflict resolution protocols.
Supervisory Relationships
Receives individual and group supervision from the Revenue Cycle Manager and/or another assigned management staff person.
Qualifications
A Bachelor’s degree in a related field, with some social work or psychology coursework preferred.
Michigan Certification Board for Addiction Professionals certification or development plan required.
Prefer at least two years of work experience performing related duties in the community, especially billing and auditing clinical charts.
Must demonstrate knowledge of substance use disorders and mental health disorders.
Must have strong mathematical aptitude and the ability to work with Excel, good verbal and written communication skills and strong working relationships with all levels of management and staff.
Must have knowledge, understanding, experience or a demonstrated desired and capacity to learn current procedural terminology (CPT) coding, and Medicaid policies and procedures.
Strong computer system and application capabilities related to claims production, and generally accepted accounting procedure.
If recovering from a substance use disorder, must have a period of at least two years demonstrated sobriety to effectively carry out job duties.
Work Conditions
MMRS is a healthcare provider.
Additional stress and risk may be encountered during critical situations commensurate with our license and scope of practice.
Additional stress may be encountered to meet the deadline driven work of this position essential to agency revenue.
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