Catholic Community Services’ Foundational Community Support (FCS) Program provides Supported Housing and Supported Employment Services under the WA State Medicaid Transformation Project. Supported Housing Services are for people with complex needs and unique strengths who benefit from hands-on case management and resource connections in order to be successful in finding and maintaining housing. This Medicaid benefit is integrated throughout CCS’ diverse social service programming to support housing search and placement activities in a variety of locations, such as Rapid Re-Housing (RRH), Housing and Essential Needs (HEN), shelters, or Permanent Supportive Housing programs. Service locations are dynamic and flexible is accomplished when staff work both independently and as part of a strong team. CCS is committed to creating a welcoming and inclusive workplace and is proud to be an equal opportunity employer. Candidates from all walks of life are strongly encouraged to apply.
Position Description :
As part of the Behavioral Health Unit, this position provides administrative, billing and data entry support for Foundational Community Supports. Incumbent is expected to work fairly independently to monitor, review and track high volumes of client related data. Experience and familiarity with Excel and other Microsoft Office suite products are essential in order to generate and analyze reports that inform client service delivery as related to authorization approvals and intensity of service. This position is also responsible for tracking, monitoring and reporting back to program leadership on billable revenue for this fee-for-service program.
As a full-time position (37.5hrs/week and minimum 30hrs/week), employees are eligible for medical, dental & vision insurance coverage, pension and 403(b) plans. CCS also offers optional enrollment in supplemental cancer insurance, hospitalization and critical illness insurance. Employees accrue generous amounts of sick time and paid vacation, in addition to 13 paid holidays annually.
MAJOR DUTIES AND RESPONSIBILITIES
1. Referral and Eligibility Screening
Research client Medicaid benefits and behavioral health history in relevant databases to determine program eligibility based on complex health and risk factors.
Verify client Medicaid benefits monthly. Notify clinical staff and leadership of status changes and make necessary funding change entries in appropriate databases.
Maintain tracking list of new referrals to ensure appropriate follow up to referring partners and individuals; provide prompt and timely responses to inquiries about eligibility.
2. Data Entry, Billing and Authorization Notices
Responsible for submitting and requesting initial authorizations and re-authorizations (every 6 months) for billable services to the Amerigroup TPA.
Review the accurateness and completeness of assessments and documentation by clinician, prepare documents to send to the funder for authorization. Coordinate corrections with supervisors as needed.
Accurately track and maintain lists of authorization approvals to include start and end dates for services.
Weekly, run Program Roster report to identify any clients who are lacking an active or pending authorization and require an exit from program services.
Follow up and communicate with Amerigroup TPA for any requests for authorization that were not acknowledged or did not receive a response.
Review authorization denials and communicate with relevant team members to obtain additional justification for eligibility and resubmit assessments for approvals.
Work with program staff and supervisors to obtain any missing or incomplete documentation.
Routinely run service reports from the database to prepare and compile Medicaid claim details needed for billing. Report status updates or missing services to Program Manager.
Use Availity billing system to submit batch claims for all service provided within this contract accurately and in a timely fashion.
Review claim details and billing documents for compliance with contract requirements related to revenue reimbursement.
Reconcile payments and monitor unpaid account balances. Follow up on payment discrepancies from various funding sources.
Maintain staff roster of clinicians completing FCS services and their program location.
Provide supporting documentation and back-up for direct deposit or check payments to Accounts Receivable office.
Maintain accurate and complete records of submitted claim history, paid claims, outstanding claims and other matters related to revenue.
Ensure program leadership receives accurate and timely billing reports on a monthly basis for decision making purposes.
Maintain communication with funding contract monitors or contacts, ensuring that reporting requirements are met and any changes or updates are reviewed.
Run caseload reports to monitor length of time in services and provide to Program Manager for completion of monthly Outcomes Reports. Run reports by due dates for contract compliance.
Assist in preparing statistical reports for funding sources as needed.
Attend meetings & training as necessary with MIS team or Behavioral Health department administrative team.
Provide back-up support for administrative tasks for peers in other programs as needed and as appropriate, requested by supervisor.
3. In conjunction with program leadership and other administrative staff, perform various administrative duties as assigned
Make copies of program forms as needed.
Assist program leadership with development of new forms, brochures, or other documents needed for program development and advertising.
Assist with scanning documents and uploading to databases as needed for paperless clinical record keeping.
Cross train with other a staff as needed to ensure smooth operations.
If bilingual, provide translation (verbally or in writing) as needed by another program.
QUALIFICATIONS
Minimum Qualifications
AA degree or work experience equivalence.
Two (2) years’ experience in administrative/operations setting.
Accurate filing skills/attention to detail.
Ability to structure tasks and responsibilities within a weekly schedule in order to meet due dates and funding deadlines.
Computer skills, including proficiency Microsoft office products.
Proficiency with Microsoft Excel to include basic formulas, filters, and pivot tables.
Knowledge and experience with mental health/CD billing systems.
Familiarity with working for a not-for-profit organization.
Demonstrated ability to maintain strict confidentiality.
Ability to work as a member of a diverse team in a fast-paced setting.
Preferred Qualifications
1. BA degree.
2. Progressive responsibilities in operations support duties.
3. Familiarity with PowerBI and coding sequences to build reports that inform review of program performance metrics.
Source: Indeed.com
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