Billing Data Analyst

at  Great Livin LLC

JOB BRIEF

The Great Livin’ Group of Companies Billing Data Analyst is responsible for undertake billing operations in our accounting department. This position must review every aspect of the billing for Medicaid Home and Community Based Services (HCBS) and services provided in our Intermediate Care Facilities for Individuals with Intellectual and other Disabilities (ICF/IID with a high degree of accuracy to guarantee our revenue.
As our Billing Data Analyst, you must have a keen eye for detail. You should also be comfortable working with little supervision to meet tight deadlines as detailed in the responsibilities of this job description.
The goal will be ensuring that all documentation meets the Federal and State requirements that the billing records necessary to “fully disclose the extent of services,” care, and supplies furnished to beneficiaries, as well as to support claims billed Medicaid. That we bill correctly.

REQUIREMENTS AND SKILLS

• Proven experience as a Billing Analyst or similar accounting role
• Good knowledge of electronic billing procedures
• Proficient in MS Office (especially Excel); familiarity with databases and SQL is an asset
• Excellent communication ability
• Organizational and time-management skills
• Attention to detail
• Teamwork skills
• Ability to work independently and meet tight deadlines
• AA/BS/BA in accounting or similar field is preferred
• New Mexico Driver’s Licenses

SPECIAL REQUIREMENTS

• Valid New Mexico Driver’s License
• Valid Auto Liability Insurance
• Job Related Certification(s)/Trainings, as and when deemed necessary by Great Livin’ and / or the state of New Mexico
• Pass required background checks

RESPONSIBILITIES

• As necessary update in Therap the Individual Services Plan (ISP) Data Templates required for the Direct Support Professionals (DSP) to document the services and supports provided.
• Review progress note documentation completed by the DSP in Therap to ensure it includes the actual implementation and outcome(s) of the designated services in an individual’s Service Plan (ISP) prior to billing Medicaid for the units of service.
• Progress note content provide all the necessary supporting evidence to justify the need for the services based on criteria and support all requirements for billing.
• Review of sequential progress notes provide a snapshot of the individual over a specified time frame. Residential supports, Customized Community Supports.
• The progress notes documents how the individual was affected by the intervention or supports provided.
• Evidence that interventions are occurring and monitored for outcomes. Identifying progress toward specific goals/objective
• Provider documented Customized Community Support Individual and documented residential supports evidence of service-by-service outcome.
• The progress note contains the following: Who was there? • What service/intervention was provided? • When was the service provided? • Where was the service provided? • Why was the service provided? • How was the service provided and received?
• The progress note Justifies units billed based on the Individualized Service Plan (ISP).
• Ensure the progress note time did not overlap with other services. Every Monday through Fridy Progress must be reviewed and corrected for the prior day’s service.
• Submit necessary to Medicaid (Comagine-Provider Medicaid Portal) for approval to bill for ICF/IID services
• Collaborate with other departments to ensure billing accuracy
• Address customer complaints and questions
• Keep track of Medicaid accounts receivable and transactions
• Assist with customer account reconciliations
• Prepare and present analytical reports
• Support monthly and quarterly audits and clean ups
• Resolve any issues or mistakes
• Complete other task as necessary or assigned

OTHER RESPONSIBILITIES AND DUTIES:

• Must follow dress code per handbook and dress in a business casual attire at all times.
• Maintains clinically appropriate boundaries with clients, other employees and community member/IDT members.
• Other duties as assigned.