Reimbursement Specialist - Healthcare jobs in Jacksonville, FL

Description

GENERAL DESCRIPTION:

The Reimbursement Specialist is responsible for assisting in the billing and reimbursement function of the School Readiness and Voluntary Prekindergarten programs.

MAJOR RESPONSIBILITIES:

1. Responsible for processing all attendance rosters and adjustments in a timely manner in the EFS Mod System.
2. Responsible for running EFS reports relating to provider payments and matching these reports with the attendance rosters and other backup.
3. Mailing and/or uploading provider payments into EDS Mod and answering phone inquiries from providers regarding payments.
4. Working with Family Services Specialist to see to it that reimbursement corrections are completed accurately and adhere to ECS guidelines.
5. Running, collating and mailing monthly reports as required by the Office of Early Learning or any other state agency as may be required.
6. Completing the slot reimbursement section on the monthly invoice to the state.
7. Assist in maintaining provider records.
8. Assist in maintaining provider subcontracts
9. Maintain confidentiality in regards to information accessed in the performance of job duties.
10. Special projects as assigned.
11. Responsible for implementing the coalition’s anti-fraud plan daily activities related to prevention, detection, investigation, and reporting of possible overpayment resulting from potential fraud or abuse.

(These essential job functions are not to be construed as a complete statement of duties performed. Employees will be required to perform other related marginal duties as required.)

ORGANIZATIONAL RELATIONSHIP:

This position reports to the Reimbursement Coordinator. 

Requirements

EDUCATION AND EXPERIENCE:

•  High School Diploma required. AS degree preferred
• 1-3 years accounting, data entry, or clerical experience preferred.

SKILLS, KNOWLEDGE AND ABILITIES:

• Ability to organize and prioritize tasks.
• Ability to meet deadlines.
• Ability to work well with minimal supervision.
• Ability to work accurately under time constraints.
• Ability to communicate effectively in both oral and written form with peers,
• management and outside parties.
• Familiarity with Microsoft Word and Excel.
• Problem solving skills and empathy and respect for providers and clients.

LICENSES, CERTIFICATION OR REGISTRATIONS:

• Valid driver’s license
• Certificates of acknowledgement required: Conflict of Interest, Code of Ethics,
• Confidentiality agreements, IT Systems and Security, Anti-Fraud, HR Employee Acknowledgement Form.

ENVIRONMENTAL CONDITIONS:

• Works inside in an office environment
• Some travel required

ESSENTIAL PHYSICAL SKILLS:

• Typical Physical & Mental Demands: Requires prolonged sitting with some bending, stooping and stretching, and eye-hand coordination and manual dexterity sufficient to operate a keyboard, telephone, photocopier, calculator and other office equipment.
• Requires normal range of hearing and eyesight to communicate with clients and staff.

 (Reasonable accommodations will be made for otherwise qualified individuals with a disability)