Administrative Assistant V - Accounts Receivable Specialist

This position works as a part of the Revenue Management Team, which manages billing, collections, tracking, and reporting for approximately $30 million in client and third-party fee revenues, and supports the Fiscal Team of the Fairfax-Falls Church Community Services Board (CSB). Is also responsible for third party reimbursement functions. Monitors revenue cycle activities to analyze denial data and to resolve any issues. Works directly with insurance payers to find denials reasons, identifies trends, and works collaboratively with all stakeholders to resolve denial matters. Performs research for rejected claims to assess the root cause, proposes solutions and implements corrective actions. Leads communication with all parties to confirm the details of denials and files appeals by gathering and providing supporting documentation extracted from electronic health records (EHR) system. Superior knowledge of claims filing limitations for each payer and ability to be able to tackle the issue as well as prioritization skills are essential.

Coordinates no authorization denials in collaboration with the Utilization Management Team (UMT) to obtain necessary updates. Independently and proactively runs accounts receivable status reports on claims requiring authorization and works with UMT staff for resolution. Conducts research for denials related to non-credentialed providers and collaborates with Contracts and Credentialing staff for resolution. Periodically plans actions to adjust unrecoverable claims and makes recommendations to reduce the denials to enhance fee revenue reimbursement. Directs the process of generating automated payment reports, audits, and reconciles payments to both manual and system generated documents to ensure accuracy in payment posting. Responsible for follow-ups on daily post processing activity including but not limited to re-issuance of denied claims statements. Collaborates with insurance companies to resolve pending issues and shares findings with their supervisor. Leads communication with department contacts regarding accounting errors, billing issues as well as modifications. Responsible for keeping timely overpayment correspondence to ensure compliance with the policies. Demonstrates appropriate levels of knowledge with regards to ICD-10, CPT and/or HCPCS coding systems as well as claims forms CMS-1500 and UB-04. Receives and evaluates billing requirements from clearinghouse vendor, implements changes, and disseminates relevant information. Demonstrates initiative and knowledge to research, understand, and resolve complex financial issues. Ability to handle confidential and sensitive information.

As a senior account representative, candidate will work directly with clinical staff and third-party payers to maximize revenue for CSB services. Develops procedures and implements processes to adapt to changing requirements of third-party payers. Maintains knowledge of payer specific regulations and guidelines. Attend statewide conferences and local training courses to include webinars and other meetings to stay abreast of industry standards. Works with DAHS-PR Business Analyst and CSB Informatics staff to maintain settings in the EHR system to support efficient and effective billing. Helps create and monitor productivity reports for use by RMT staff, senior managers and clinical staff.

In collaboration with the FS II manages and directs administrative staff responsible for third party reimbursement functions. Manages and directs Administrative Assistant IVs in collaboration with the third-party team supervisor. Leads the effort to develop performance standards and goals. Assesses performance on an ongoing basis to include yearly pay for performance evaluations. Periodically reviews position descriptions updating as needed. Participates in the hiring process by being on interview panels and making recommendations for new hires to the third-party team supervisor. Monitors workflow and assign priorities to ensure timely completion of reimbursement tasks as well as uniformity in documentation. Coordinates staff absences and ensures adequate team coverage. Provides direction and leadership in difficult situations. Coach employees and work to maintain a congenial working atmosphere.

This position works under the general supervision of Financial Specialist II (FSII).

Functional areas: Finance

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(The illustrative duties listed in this specification are representative of the class but are not an all-inclusive list. A complete list of position duties and unique physical requirements can be found in the position job description.)

General Financial Duties

• Supervises a group of clerical/accounting personnel performing duties at the Asst. III level;
• Determines, modifies, and implements administrative policies, procedures and methods to improve office practices;
• Designs and uses spreadsheets and databases to interpret and organize resource information;
• Provides customized reports to analysts or others in the unit.

• Analyzes data and develops budget recommendations and projections for unit;
• Administers several complex funds, projects, contracts and/or grants;
• Processes journal and/or budget entries (e.g., change orders, accruals).

• Performs duties requiring entry level professional knowledge of basic accounting principles;
• Reconciles and monitors unit's accounting processes;
• Resolves non-routine and complex problems.
• Prepares wire transfers;
• Performs unique accounting functions that have department-wide impact.

• Researches and recommends equipment/vendors and prices;
• Determines substitutes for supplies and high value equipment;
• Coordinates the purchase of non-standard items (e.g., purchases requiring coordination with other departments, multi-fund purchases, and/or biohazardous material acquisition);
• Resolves issues and disputes with vendors and/or identifies need for increased levels of contract monitoring;
• Acquires insurance via county Risk Management.

• Provides advice and counsel to members of the executive/work unit head's functional area;
• Exercises discretion in administrative policy interpretation;
• Resolves a wide variety of operational problems requiring sound judgment.
• Acts as the liaison between the executive/work unit head's functional area, other county offices, and external agencies;
• Recommends exceptions to administrative policies that are subject to review.

• Supervises or handles the most complex, non-routine activities where consequence of error is high;
• Coordinates all logistic activities for visits by external groups;
• Schedules/sets up presentation rooms, obtains required audiovisual equipment, schedules order of presentations, length, etc.;
• Verifies travel arrangements made by visitors (e.g., travel to/from hotel);
• Makes all arrangements required by visitors regarding catering or supplies;
• Directs or performs the scheduling, organizing, coordinating and making of arrangements for national and international meetings;
• Negotiates prices for goods and services required at meetings;
• Manages the calendar of the executive/work unit head with authority to make commitments of the executive/work unit head's time and to distinguish higher from lower priorities in the executive/work unit head's schedule.

• Independently composes original correspondence (e.g., preparation of replies to non-technical requests) for the functional area under their own signature;
• Explains and interprets policies as they apply to unique situations with potential legal and safety implications;
• Researches, coordinates, and provides information to others including citizens, executive/work unit head, and/or BOS members/staff;
• Informs internal staff regarding executive/work unit head's decisions regarding procedural issues and provides the reasons for those decisions.

• Supervises several dissimilar or specialized functions each with unique training requirements;
• Devises procedures for complex or specialized functions;
• Anticipates and develops procedures/tools to prevent problems; solves unusual problems;
• Provides administrative support to the functional area (e.g., reviews, evaluates and prioritizes all requests and communications;
• Analyzes short and long-range administrative needs such as space, staffing of functional area).

• Responsible for and determines administrative procedures.

• Answers questions requiring decisions that tend to establish a precedent and/or commit a unit or supervisor to a course of action;
• Recommends procedural changes;
• Interprets policies and provides oral and/or written interpretations/procedures for non-routine/complex problems referred by front line staff.

• Supervises word processing staff including training of staff;
• Edits for style, format, and/or layout.

• Trains staff in use of agency information systems/software;
• Researches & selects hardware/software;
• Creates complex spreadsheets for department;
• Operates/manages complex databases & other software using advanced functions;
• Diagnoses and resolves hardware/software problems using substantive computer/software knowledge.

• Prepares one of a kind reports, gathers statistics based on information compiled from various sources, draws conclusions, and makes recommendations.

• Supervises all personnel administrative functions for the department;
• Reviews new departmental policies for HR implications and recommends and implements administrative changes;
• Researches and recommends solutions to non-routine/one-of-a-kind problems;
• Drafts and coordinates approval of documents that include "boilerplate" language for matters related to HR (e.g., underfill agreements);
• Works with hiring manager to coordinate appointment and review process;
• Reviews class specifications and recommends requested job classification;
• Develops administrative HR-related procedures for agency.

(The knowledge, skills and abilities listed in this specification are representative of the class but are not an all-inclusive list.)

Knowledge of county policies within functional area of responsibility. This may include knowledge of an outside institution, dissimilar operational unit within the county or the basic principles and methods of a professional field.

Executive Assistance

• Thorough knowledge of the executive/work unit head's program/area and of county administration and organization.
• Ability to maintain confidentiality and be sensitive to political issues.
• Knowledge and sensitivity to issues, priorities, protocol, etc.

• Basic math skills.

• Intermediate skills in the use of applicable Microsoft Office Suite software;
• Intermediate skills in the use of agency specific software applications.

• Ability to communicate well through written and oral means;
• Ability to speak in front of a group.

• Ability to gather, integrate, and analyze complex data.

• Ability to establish and maintain effective working relationships with both external and internal contacts.

• Ability to perform data entry into Purchasing/Logistics Enterprise Resource Planning systems and/or Financial Enterprise Resource Planning systems in at least eight functions.

• Ability to perform all human Capital Management Enterprise Resource Planning system functions.

MINIMUM QUALIFICATIONS:
Any combination of education, experience and training equivalent to high school graduation and four years of experience providing administrative support in the assigned functional area(s).

NECESSARY SPECIAL REQUIREMENTS:
The appointee to this position will be required to complete a criminal background check, a Child Protective Services Registry check, and sanction screening to the satisfaction of the employer. A TB screening upon hire.

PREFERRED QUALIFICATIONS:

• Experience with and understands Generally Accepted Accounting Practices (GAAP).
• Experience in revenue cycle management, including the handling of insurance claims, payment postings, insurance follow up, denial and appeals processes.
• Experience using billing systems and electronic health record (EHR) platforms, ability to effectively use and navigate all payer portals. Ability to document EHR in professional, appropriate, accurately depicts actions performed, and is in accordance with departmental quality review standards.
• Excellent customer service skills with the ability to interact in a friendly, service-oriented professional manner with internal and external customers.
• Experience interpreting and making decisions based on policies and procedures.
• Supervisory experience to include planning, organizing, coordinating, assigning, and evaluating the work of staff.
• Ability to work independently and in a team environment, be proactive, exercise good judgement and use critical thinking skills.
• Have excellent verbal and written communication skills and advanced proficiency with MS Excel, Pivot Tables, Outlook and Word.
• Demonstrated ability to work with limited supervision, set priorities, and multi-task.
• Demonstrated ability in resolving complex problems in a team-based environment, balancing multiple priorities, making presentations to senior managers and groups.