STATE CLASSIFICATION JOB DESCRIPTION


Salary Group B12

Class No. 1242

REIMBURSEMENT OFFICER I

GENERAL DESCRIPTION

Performs routine (journey-level) reimbursement or claims processing work.  Work involves determining eligibility; obtaining financial information; maintaining accounts; and collecting charges for the support, maintenance, and treatment provided to clients.  Works under moderate supervision, with limited latitude for the use of initiative and independent judgment.

EXAMPLES OF WORK PERFORMED

Reviews and analyzes documents to identify and determine the appropriate claim source.

Analyzes financial information for ability-to-pay determinations.

Interviews clients, relatives, or guardians of clients to determine the proper rates to be charged for support, maintenance, and treatment provided to clients.

Prepares correspondence, forms, and reports; and maintains records of assigned cases.

Prepares claim forms necessary to obtain reimbursement from insurance companies and governmental agencies.

Collects payments from clients based on their ability to pay for services.

Refers claims or accounts requiring legal assistance to appropriate staff.

Establishes and maintains accounts in databases or applicable computer systems.

May assist in processing protests and appeals.

May assist in establishing charges and procedures for the collection of accounts.

May take appropriate action to collect, adjust, or write off delinquent charges.

Performs related work as assigned.

GENERAL QUALIFICATION GUIDELINES

Experience and Education

Experience in claims processing and health-related account and collection work.  Graduation from a standard senior high school or equivalent is generally preferred.  Experience and education may be substituted for one another.

Knowledge, Skills, and Abilities

Knowledge of the principles of collection and accounting, and of the rules and regulations governing reimbursement for agency services.

Skill in interviewing techniques, in the use of general office equipment, and in the operation of computers and applicable computer software.

Ability to communicate effectively.


State Auditor’s Office

Revised 9-1-17