STATE CLASSIFICATION JOB DESCRIPTION


Salary Group B18

Class No. 1248

REIMBURSEMENT OFFICER IV

GENERAL DESCRIPTION

Performs advanced (senior-level) reimbursement or claims processing work.  Work involves performing, coordinating, and monitoring billing and collection activities.  May assign and/or supervise the work of others.  Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment.

EXAMPLES OF WORK PERFORMED

Performs and/or oversees staff engaged in financial interviewing, financial investigations, asset research, and fee determinations.

Coordinates and monitors billing and collection activities.

Conducts reviews to monitor compliance with state and federal laws, rules, and regulations pertaining to reimbursements that are highly complex in nature or large in scale.

Conducts investigations that are highly complex in nature or large in scale and determines amounts to be charged for care and treatment based on findings.

Assesses training needs based on observations and monitoring of reimbursement programs.

Determines proper payment and collection of charges and issuance of payment on claims.

Resolves billing problems and financial determinations.

Interprets, establishes, and implements policies and procedures.

Prepares and disseminates reports and information involving policies, procedures, and activities.

Gathers financial data to be used in reports to management.

May coordinate, plan, and conduct training sessions, workshops, and seminars.

May assign and/or supervise the work of others.

Performs related work as assigned.

GENERAL QUALIFICATION GUIDELINES

Experience and Education

Experience in claims processing and health-related account and collection work, including supervisory experience.  Graduation from an accredited four-year college or university with major course work in business administration or a related field 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 resolving problems, in reviewing and evaluating options, in implementing solutions, in interviewing techniques, in the use of general office equipment, and in the operation of computers and applicable computer software.

Ability to communicate effectively; and to assign and/or supervise the work of others.


State Auditor’s Office

Revised 9-1-17