The Department of Mental Health is a drug-free workplace. All candidates will be required to pass a mandatory pre-employment drug test.
This position is located at the Department of Mental Health, Waccamaw Center for Mental Health, 164 Waccamaw Medical Park Drive, Conway, SC 29526.
Under direct supervision of the Administrator, directs and oversees reimbursement procedures for WCMH, in compliance with DMH and all regulatory agencies. Manages billing revenue relative to Medicaid/MCOs, Medicare, self-pay and other insurance productivity and performs statistical reports associated with financial activity. Recommends and institutes changes in reimbursement guidelines in order to maximize reimbursements earned and received by WCMH. Directs the WCMH billing department to implement, maintain, and develop, as necessary, appropriate billing systems and files to meet DMH billing policies and procedures and to provide appropriate levels of control and audit trails. Ensures and oversees all eligible Medicaid/MCO, self-pay and other insurance billings are processed on a monthly basis, as necessary, in a timely manner. Monitors, identifies and resolves outstanding claims on a monthly basis to ensure accurate payment of services.
Prepares monthly billing reports for the executive staff. Notifies self-pay and third party payors of any billing discrepancies and prepares financial statements for payback when required. Informs supervisor of problem areas. Ensures and oversees the accurate posting of Medicare, Medicaid/MCOs, self-pay and other insurance payments into computer and balancing with remittance advices and EOB’s. Processes all Medicaid payments and adjustments as needed or requested. Serves as the subject matter expert on DMH billing policies, procedures and electronic databases, including the CIS, EMR and Crystal Report reporting systems to ensure accurate and timely billing of all payor sources. Attends SCDMH billing meetings and updates Supervisor and Director accordingly. Reports all billing related audits, paybacks, write-offs and other adjustments as needed.
Oversees and provides new and ongoing support and training for all of WCMH’s Office Managers, business offices and new staff. Oversees self-pay collections reporting and procedures to ensure accurate collection and reporting on a monthly basis. Ensures that the business offices’ staff members have access to appropriate online resources.
Functions as CIS Coordinator for WCMH. Maintains CIS billing files and updates all databases as needed. Back-up to EMR. Backs up the Crystal Administrator. Maintains documentation of charts and other records in accordance with State, Federal, local, SCDMH, WCMH, Quality Assurance, Corporate Compliance and CARF Standards. Attends all mandatory trainings as required to be compliant with billing protocol.
Performs other duties as required by Supervisor and/or Executive Director.
Minimum and Additional Requirements:
A high school diploma and relevant experience in business management, public administration, or administrative services or a bachelor’s degree may be substituted for the required work experience.
Note: If any Agency Requirements are listed above, applicants must also meet those requirements to be considered for the position.
Preferred knowledge of third party payor systems and their requirements, particularly as they apply to state agencies. Must be able to work independently and prioritize accordingly. Must have ability to develop and report complex statistical information as requested. Must have good organizational and communication skills.
Some travel may be required.
Supplemental questions are considered part of your official application. Please complete the state application to include all current and previous work history and education. A resume may be attached, but not substituted for completing work history and education sections of the employment application. The employment application will be considered incomplete and not forwarded.