Billing Supervisor- Pueblo/denver

State of Colorado
Full Time 40 per week $86,916 - $109,000 Per year CO Colorado
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Overview

Department Information

THIS ANNOUNCEMENT IS OPEN TO CURRENT RESIDENTS OF COLORADO ONLY
This position will be paid bi-weekly.


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Office of Behavioral HealthThe Mental Health Hospitals at Fort Logan and Pueblo and Forensic Services, under the auspices of the Office of Civil & Forensics Mental Health (OCFMH), partners with patients, families and their communities to provide quality services that assist patients in achieving their mental health and health care goals. In addition, Mental Health Institute at Pueblo is the only Colorado facility with a forensic division that serves adults who are found Not Guilty by Reason of Insanity or found Incompetent to proceed.


The Finance and Contracts Services Units, located in the Office of Civil and Forensic Mental Health’s CFO office, exists to provide critical fiscal and contracts support and guidance for the Mental Health Institutes and the Forensic Services Division. The Units provide program guidance with respect to governmental budgeting and analysis, hospital finance, and assistance with governmental medical contracts, solicitations, and procurements within the State of Colorado. The Units provide review and reconciliation of personal services databases, including PAF creation and processing. 
 

Description of Job

The Billing Supervisor in this position will directly supervise the creation and submission of Medicare and DOC claims for timely filing to maximize agency revenue. This position determines and notifies various Institute and Department staff of outside medical liability for patients admitted to outside acute hospitals. The Program Manager reviews, analyzes, and interprets AVATAR – PM reports to ensure the accuracy of revenue and receivables as reported in CORE. In addition, this position reviews Ability to Pay (ATP) calculations to ensure compliance with state statutes, rules, and regulations. The position has signature authority for ATP calculations, administrative adjustments, and other management authorizations as assigned. Position reviews payments from third parties and advises immediate supervisor of any unusual problems. Position is responsible for performance evaluations, work schedules, training, and writing procedures by which section will operate and reviews work for conformance with established rules and regulations. Position serves as backup subject matter expert for patient billing issues.


As a Billing Supervisor, you can expect to:

  • Monitor submission of Medicare and DOC medical claims for Colorado Mental Health Institute Pueblo and Ft. Logan for timely filing (which includes interpreting timely filing rules), analyze accuracy of billings, and investigate billings to ensure maximization of agency revenue
  • Reconcile, investigate, and rebill for all outstanding Institutes Medicare and DOC billings. Record monthly revenue, and investigate and make appropriate adjustments in CORE (preparation and input of JVs) to adjust revenue in reconciliation/correction process
  • Summarize and report statistics utilized in the preparation of the annual Medicare Cost Report. Review Medicare billing logs and verify the logs for accuracy. This includes analysis of appropriate accounts to be claimed as Medicare Bad Debt. Defend calculations and respond to questions from auditors on information provided.
  • Directly supervise two (2) technicians and one (1) professional position, which includes scheduling and delegating work; approve time off; handle performance issues; train employees; prepare performance plans and ratings; recommend need for progressive discipline; interview applicants, and recommend choice for hire, promotion, or transfer
  • Monitor staff accuracy and proficiency in the processing of Medicare claims, outside medical payments, and general office duties, document problem areas, then provide further training or counseling if performance does not improve.
  •  Review and approve Ability to Pay (ATP) calculations for CMHIP and CMHIFL, ensuring compliance with state statutes, rules, and regulations. Review ATP appeals. Reconcile and adjust self-pay accounts requiring supervisory review as identified by technicians. Signature authority for ability to pay approvals. Recommend reviews of full-rate ATPs to Director of Patients' Accounts for possible reduced or no ATP payment determinations
  • Audit outside medical payments verifying payee, quantities, and dollar amounts on invoices, by applying knowledge of state fiscal rules and DHS policy, and interpretation of fiscal rules; verify invoices and statements, and proper signature authority; review or recommend coding by fund, agency, organization unit, appropriation, object, sub-object, grant budget line, balance sheet account, and reporting category
  • Analyze correct object code to be used for consistency and accuracy of payments. Evaluate whether payment, coding, and attached documentation are accurate and complete if payment voucher is requested for a state audit. Analyze, interpret, and resolve best object code to use for atypical purchases. Advise technicians and internal customers as to best object code to use for goods and services. When discrepancies arise, pursue resolution by analyzing, interpreting, evaluating, and investigating. Upon verifying accuracy, indicate approval by signing the voucher as audited, and approve the document in CORE. 
  • Performs other duties as assigned

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

Minimum Qualifications:

Experience Only:
Eight (8) years of relevant experience in an occupation related to the work assigned
to this position

OR

Education and Experience:
A combination of related education and/or relevant experience in an occupation
related to the work assigned equal to eight (8) years


Preferred Qualifications:

  • Experience with Avatar and CORE 
  • Familiar with patient billing
  • Familiar with Medicare Medicaid rules and regulations 
  • Familiar with Colorado Revised Statutes related to billing and the Institutes 
  • Familiar with Social Security Administration rules and regulations 
  • Previous Supervisory Experience  
  • Ability to communicate with patients and/or their families 
  • Proficient with Microsoft Access 
  • Proficient with Microsoft Word 
 

 
Conditions of Employment: 
  • A pre-employment criminal background check will be conducted as part of the selection process as this position is deemed to have direct contact with vulnerable persons. Felony convictions, conviction of crimes of moral turpitude, or convictions of misdemeanors related to job duties may disqualify you from being considered for this position. Should your background check reveal any charges or convictions, it is your responsibility to provide the CDHS Background Unit with an official disposition of any charges
  • Must possess a valid, unrestricted U.S. Driver's License
  • This position works with confidential Information, and is expected to maintain confidentiality at all times
  • May be required to work in excess of 40 hours per week to complete assigned duties, meet deadlines or as requested by supervisor 
  • Occasional travel necessary to attend training, using state fleet vehicle.
  • Former employees of the Colorado Department of Human Services (CDHS) who were disciplinary terminated or resigned in lieu of termination must disclose the information on your application and may not be eligible for employment at CDHS
 
APPEAL RIGHTS:

If you receive notice that you have been eliminated from consideration for this position, you may file an appeal with the State Personnel Board or request a review by the State Personnel Director.

An appeal or review must be submitted on the official appeal form, signed by you or your representative. This form must be delivered to the State Personnel Board by email, US Mail, faxed or hand delivered within ten (10) calendar days from your receipt of notice or acknowledgement of the department’s action.

For more information about the appeals process, the official appeal form, and how to deliver it to the State Personnel Board go to  or refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at  under Rules.

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