Hybrid Senior Accountant for Medical Coding and Reve bei YWCA Kalamazoo

PRIMARY FUNCTION: 

With general guidance from the Director of Finance, the Senior Accountant for Revenue serves as a member of the accounting team and serves two major functions:  

1. Directly manages the billing and related monthly and periodic financial reporting and invoicing for Child Care and other departments within the organization.  
2. Directly manages and is responsible for ensuring accurate coding billing, timely submission of electronic claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. The medical coding, billing and collection specialist must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments based on payer contracts or government regulations. In addition, the medical coding, billing and collection specialist must demonstrate proficiency with the billing system to ensure all functionality is utilized for the utmost efficient processing of claims. 

Additionally, The Senior Accountant will provide supervision and guidance to childcare billing staff positions. Acts as liaison to Vice Presidents and Directors to ensure timely communication of accurate financial and compliance information for accounts receivable for budget planning.  Assists in the facilitation of audits and site visits.  Provides assistance with general accounting/reporting needs.  Maintains general knowledge of government and private billing processes.  Reports to Director of Finance. Implements the YWCA’s Mission, Purpose, and One Imperative.    

QUALIFICATIONS:  

1. Possess an associate’s degree; Bachelor’s degree in a business-related or health-care related field preferred
2. Certified Coder and Biller preferred (If certification has not been achieved, it must be obtained within 12 months of employment)

3. Minimum of five years of related experience in a business, medical or technical environment 

4. Knowledge of computerized billing systems, specifically eCW preferred
5. Knowledge of credit and collection principles, processes, regulations, and standards
6. Knowledge of cash management principles and/or procedures
7. Ability to develop and maintain recordkeeping systems and procedures
8. Knowledge of operational characteristics and procedural requirements of payors
9. Must have a high degree of computer software literacy using Microsoft Office
10. Previous experience in a medical office setting and/or experience with an Electronic Medical Record, eClinical Works (eCW) experience preferred
11. Customer service driven
12. Understanding of medical terminology and insurance laws/guidelines 
13. Experience in a non-profit setting is preferred
14. Knowledge of the principles, procedures, and best practices in accounting, revenue recognition, childcare tuition billing and/or medical provider billing
15. Ability to read, analyze, and interpret general health and social services guidelines, technical procedures or governmental regulations 
16. Ability to write reports, correspondence and policy/procedure instructions
17. Ability to effectively present information and respond to questions from groups, payers, practice managers, patients, staff, and the public
18. Ability to solve practical problems and deal with a variety of concrete variables in situations where limited standardization exists
19. Ability to interpret a variety of instructions furnished in written, oral, or diagram form
20. Understanding of accounts receivable. 
21. Demonstrated ability to manage deadlines, work well under pressure and in situations that require teamwork.
22. Strong supervisory and leadership skills.
23. Demonstrated strong oral and written communication skills.  Ability to translate financial information to non-financially trained staff.
24. Demonstrated ability to work with people of diverse backgrounds.

25. Acute attention to detail.
26. Ability to calculate figures and amounts such as ratios and percentages. 

27. Strong organizational, problem-solving, and analytical skills; able to manage priorities and workflow.
28. Commitment to excellence, high standards and the mission of the organization.  
29. Ability to develop rapport with people of all levels in the organization. 
30. Ability to respond effectively to the most sensitive inquiries or complaints. 
31. Demonstrated highly effective oral and written communication and organizational skills. 

The following statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.

DUTIES/RESPONSIBILITIES:

• Responsible for charge and payment entry within the electronic health record (EHR)
• Coordinates and clarifies with the care team, when necessary, on information that seems incomplete or is lacking for proper account/ claim adjudication
• Responsible for correcting, completing, and processing claims for all payer codes • Update patients’ demographics including payer information
• Maintain appropriate internal controls over accounts receivables/cash receipts, and monitor charge posting, billing, and collection operations for compliance with established policies, regulations, procedures, and standards
• Assist in reconciling deposit and patient collections
• Assist with billing audit related information
• Process refund requests
• Analyze and interpret that claims are accurately sent to insurance companies
• Perform follow-up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports
• Process appeals online or via paper submission
• Attend meetings or workshops when needed 
• Communicate with credentialing coordinator to identify and resolve payer contracting issues • Available to answer coding and billing inquiries by patients, staff, payers, etc. 
• Communicate daily with internal and external customers via phone calls and written communications 
• Identify trends, and carrier issues relating to medical coding, billing and reimbursements and report findings to Supervisor 
• Research, record findings, and communicate effectively with Supervisor to achieve optimum performance 
• Pursue, participate and report on educational activities to remain current with changes in the healthcare industry 
• Pursue, participate and report on activities impacting provider delivered care management and Psychiatric Collaborative Care (CoCM) coding and billing
• Maintain patient confidentiality and protect office operations by keeping patient information confidential and adhering to HIPAA Privacy rules 
• Contribute to team effort by accomplishing related results as needed 
• Promote effective working relations and work effectively as part of a team to facilitate the care team’s ability to meet its goals and objectives 
• Perform other duties as assigned to support Medical Network One
• Conducts all billing for Child Care services including and not limited to DHHS, Tuition reimbursement, CACFP, CAPE along with all reimbursement claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.
• Acts as Liaison between Finance and Child Care Centers and specific departments/programs as assigned and is supportive management needs.
• Oversees verification of all account coding, ensuring appropriateness in relation to grant and contract expenditures, fiscal commitments, and approved budgets.
• Conducts billing for other programmatic services as assigned.
• Serves as the practice expert and go-to person for Dreamery billing processes and procedures, as well as for medical coding and billing
• Analyze billing and claims for accuracy and completeness; submit claims to proper grant entities and follow up on any issues. Follow up on claims using various systems.
• Maintains contacts with site director, therapists, and teachers.
• Responsible for monthly revenue recognition including journal entries, analysis, and ad hoc reports. 
• Prepares and analyzes weekly and monthly revenue, and reimbursement reports 
• Performs balance sheet reconciliation for related receivable accounts. 
• Supports the cash receipt process and ensures appropriate revenue recognition.  
• Ensures the activities of the billing operations are conducted consistently with overall department protocol and follow federal, state, and payer regulations, guidelines, and requirements.
• Supports the development and implementation of operating policies and procedures.
• Work cooperatively with the Director of Finance and program staff in the implementation and practical application of accounting and finance recommendations and systems as needed. 
• Lead in the verification of all funding for childcare and medical programs and grants.
• Work collaboratively to identify discrepancies and delinquent accounts. 
• Under the direction of the Director of Finance, assist in the organization’s annual audit of financial statements, including work-paper preparation, recommendations, and corrective actions.
• Provide training and education to all staff in billing requirements and procedures.
• Comply with applicable local, state, and federal requirements, certifications, and/or regulations.
• Comply with organization policies and procedures.

GENERAL EXPECTATIONS:

• Assists with related special projects as required.
• Comply with Association policy regarding required reporting of child abuse, elder abuse, suicide, and homicide.
• Safeguard confidential information gained because of job.
• As a YWCA employee, project a positive image of the Association and its programs to the community and the Association.
• Work cooperatively with program participants, YWCA staff, volunteers, contractors, and vendors.
• Participate in local, state, and national professional networks as required.
• Performs other related duties as assigned.

COMPETENCIES:

• Judgement.  Displays willingness to make decisions; Exhibits sound and accurate judgement; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; makes timely decisions.
• Planning/Organizing.  Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives; Organizes or schedules other people and their tasks; Develops realistic action plans.
• Professionalism.  Approaches others with tact; Manages pressure and stress in a positive manner; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. 
• Quality.  Demonstrates accuracy and thoroughness; Seeks ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
• Adaptability.  Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to effectively manage change, delays, or unexpected events. 

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

• Occasionally required to stand.
• Continually required to sit.
• Continually required to utilize hand and finger dexterity.
• Occasionally required to bend, stoop, kneel.
• Frequently required to talk or hear.
• Continually utilize visual acuity to operate equipment, read technical information, and/or use a keyboard.
• Occasionally required to lift/push/carry items up to 25 pounds.

TRAINING REQUIREMENTS:

1. Orientation to YWCA Personnel Policies, Mission, Purpose and One Imperative.
2. Racial Justice Training
3. Orientation to Domestic Violence, Sexual Assault, Confidentiality, Mandatory Reporting.
4. Other appropriate training and in-service which will occur during employment.

The above is intended to describe the general content of and requirements for the performance of this job.  It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements.  Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Equal Opportunity Employer