REVENUE ADMINISTRATOR I - SES - 64035826 1

Date: Jan 29, 2025

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Requisition No: 845728

Agency: Department of Health

Working Title: REVENUE ADMINISTRATOR I - SES - 64035826 1

Pay Plan: SES

Position Number: 64035826

Salary: $45,000 - $48,000 annually

Posting Closing Date: 02/04/2025

Total Compensation Estimator Tool (https://compcalculator.myflorida.com/)

INTERNAL AGENCY POSTING ONLY

Thank you for your interest in career opportunities with the Florida Department of Health in Polk County. If you are looking to establish a successful career in Public Health, you have come to the right place. Many of our innovative and successful health programs are recognized throughout Florida. We hope you decide to join our team! Applicants will be contacted directly if selected for an interview.

This incumbent is part of a global public health organization and is expected to support the Florida Department of Health in Polk County in its mission to protect, promote, and improve the health of all people in Florida through integrated state, county and community efforts and its vision to be the Healthiest State in the Nation. Furthermore, the incumbent is expected to incorporate the agency values inInnovation, Collaboration, Accountability, Responsiveness and Excellencein all aspects of their work.

Your Specific Responsibilities:

Managed Care: Responsible for negotiating, reviewing, analyzing, and processing complex service contracts with managed care organizations and third-party payers. Manages the overall contracting process including documents, maintenance and distributions, resolution of operational, administrative, and clinical issues among internal and external customers. Serves as expert resource to FDOH-Polk and Hardee staff with regards to managed care contract planning, development, interpretation, implementation, and maintenance. Establishes and maintains a good working relationship with managed care organizations. Performs contract analysis, assembles data, and provides health care contracting practices, and/or government regulations. Identifies, analyzes, and evaluates contractual compliance issues, resolves, or facilitates resolution of compliance-related problems as appropriate. Establishes billing procedures in accordance with managed care/third party contracts and Florida Medicaid.

Medicaid/Medicare: Serves as expert resource to FDOH-Polk and Hardee staff on Florida Medicaid policies and Medicare. Maintains current knowledge of Florida Medicaid and Medicare policies and procedures.

Billing/Accounts Receivables: Monitors outstanding accounts receivables on a timely basis to meet specific measurables objectives and to assure compliance with statewide operational goals. Prepares reports on analysis of accounts receivables and aging. Responsible for follow-up on late receipts and pursuit of alternative collection methods. Prepares report analysis on accounts receivable collections to include Medicaid, Medicare, Managed Care contracts, other third-party contracts, and self-pays. Prepares report analysis on insurance billing denials indicating recurring patterns and corrective action steps. Assists in developing, modifying, and implementing billing and management reporting systems. Identifies problems and makes recommendations for appropriate modifications to billing & collection procedures. Assures proper billing codes are utilized and guidelines are followed along with timely submittal of invoices or insurance claims. Maintains current knowledge of DOH billing systems.

Supervisory: Performs supervisory duties including but not limited to, hiring and selection, developing performance plans, conducting performance evaluations timely, planning & directing work assignments, approving leave, and taking disciplinary action. Responsible for review, corrections, and timely approval of staff timesheets. Trains staff to ensure that the functions are performed effectively. Directs the work of employees to ensure best use of time & resources. Ensures coverage at all times of all positions within the accounts receivable section. Motivates employees to provide and improve the quality and quantity of work performed through communication on a regular basis both individually and through staff meetings.

Review Electronic Health Records for accuracy and completion. Notate clinical errors in the record. Track errors and communicate with managerial staff to ensure encounters are billable. Summarize findings by provider with correction action and meet with providers to review.

Acts as practice management lead for HMS pilots. Reviews notes, communicates changes, and trains staff accordingly.

Administration: Assist the Financial Administrator with improving policies and procedures, contract management, and financial reports. Meets as needed with divisions and budget managers to assist in reconciling revenue concerns and project various cost centered revenues. Prepares, submits, and maintains all Provider credentialing for FDOH-Polk and FDOH-Hardee. Performs quarterly CAQH attestations. Maintains credentialing database of provider documents including licenses, board certifications, DEA’s and CPR certifications. Responsible for training staff on billing codes and functions within HMS. Acts as FMMIS Security Administrator and HMS Billing Administrator. Maintains proper internal controls. Assures performance measures are being met or surpassed and implements corrective measures to improve on deficiencies. Consults with program supervisors to resolve programmatic, administrative, and operational issues.

Incumbent is required to work during or beyond normal work hours or days in the event of an emergency. Emergency operations functions required of the incumbent include, but are not limited to, Special Needs Shelters, Red Cross Shelters, or other emergency functions. This position may serve clients that speak only Spanish, Creole, or other languages. It may require performance of interpreter duties, if bilingual, or implementation of the Department’s limited English Proficiency Plan.

Performs other duties assigned by supervisor.

Required Knowledge, Skills, and Abilities:

• Knowledge of: Knowledge of AHCA policies and procedures. Billing knowledge and/or experience with Medicare, Medicaid, 3rd Party Insurance and client accounts receivables. Knowledge of budgets, accounting principles, practices, and procedures. Knowledge of the methods of data collection and mathematics. Knowledge of computers and Microsoft Office software (Word, Excel, PowerPoint, Access, Outlook).

• Skills in: Decision making, problem solving, critical thinking, computer software use- Microsoft Office- Word, Excel, PowerPoint, Access, Outlook. Public speaking and presentations, Writing and developing written financial reports, Time management, Active listening, Mathematics, Human Resource Management, Customer Service, Communication.

• Abilities to: Negotiate contracts and agreements with private agencies, collect, evaluate, and analyze data relating to financial program functions, organize data into a logical format, design and implement management reporting systems, prepare, analyze, interpret and maintain management reports and data, compose correspondence, solve problems and make decisions, work independently, solve problems and make decisions, understand and apply applicable rules, regulations, policies and procedures relating to billing functions, accounts receivables, personnel and accounting functions, formulate policies and procedures, prepare and administer budgets, analyze and interpret financial data, prepare and maintain accounting records, plan, organize, supervise, coordinate, and evaluate work activities of others and determine work priorities while assigning and ensuring completion of work assignments, communicate effectively, establish and maintain effective working relationships with others, provide consultation and advise to others. Proficiency in MS Office Word, Outlook, PowerPoint and Excel.

  Qualifications:

• High School Diploma

• Medical Coding Certification preferred

  Other job-related requirements for this position:

  Emergency Duty: Incumbent may be required to work before, during and/or beyond normal work hours or days in the event of an emergency. Emergency duty required of the incumbent includes working in special needs or Red Cross shelters, or performing other emergency duties including, but not limited to, responses to or threats involving any disaster or threat of disaster, man-made or natural.

  Confidentiality:Incumbent may have access to records containing Social Security numbers in the performance of their job duties.

  Florida Department of Health Mission, Vision, and Values:

  Mission:

  To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.

  Vision:

  To be the Healthiest State in the Nation.

  Values:

  I nnovation: We search for creative solutions and manage resources wisely.

  C ollaboration: We use teamwork to achieve common goals & solve problems.

  A ccountability: We perform with integrity & respect.

  R esponsiveness: We achieve our mission by serving our customers & engaging our partners.

  E xcellence: We promote quality outcomes through learning & continuous performance improvement.

  Where You Will Work:

  Bartow, FL

  The Benefits of Working for the State of Florida:

  Working for the State of Florida is more than a paycheck. The State’s total compensation package for employees features a highly competitive set of employee benefits including:

• Annual and Sick Leave benefits;

• Nine paid holidays and one Personal Holiday each year;

• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options;

• Retirement plan options, including employer contributions

  (For more information, please click www.myfrs.com );

• Flexible Spending Accounts;

• Tuition waivers;

• And more!

  For a more complete list of benefits, including monthly costs, visit www.mybenefits.myflorida.com .

  Please be advised:

  Your responses to qualifying questions for this position must be verifiable by documentation provided through the electronic application process.

  This position requires a security background check and/or drug screening and participation in direct deposit. Any misrepresentations or omissions will disqualify you from employment consideration. Note: You will be required to provide your Social Security Number (SSN) in order to conduct this background check Successful completion of a drug test is a condition of employment for safety-sensitive positions.

  Male applicants born on or after October 1, 1962, will not be eligible for hire or promotion unless they are registered with the Selective Services System (SSS) before their 26th birthday, or have a Letter of Registration Exemption from the SSS. For more information, please visit the SSS website: http://www.sss.gov

  If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. Your current retirement benefits may be canceled, suspended or deemed ineligible depending upon the date of your retirement.

  The successful candidate will be required to complete the Form I-9 and that information will be verified using the E-Verify system. E-Verify is operated by the Department of Homeland Security in partnership with the Social Security Administration to verify employment eligibility.

  Incumbents may be required to perform emergency duty before, during, and/or beyond normal work hours or days.

  Florida has the third largest population of veterans in the nation with more than 1.5 million service men and women. The Florida Department of Health (department) is committed to serving members of the United States Armed Forces, veterans and their families by encouraging them to apply for vacancies that fit their area of knowledge and/or expertise. Through the Department's VALOR program, which expedites licensing for military veterans, the Department also waives initial licensing and application fees for military veterans who apply for a health care professional license within 60 months of an honorable discharge. These initiatives help ensure that the transition from military service into the workforce is as smooth as possible and reflects our appreciation for the dedication devoted to protecting our country.

  If there are any problems applying online, please call People First Staffing Administration: (877) 562-7287.

  Service Center hours are Monday through Friday, 8:00 a.m. to 6:00 p.m., ET. TTY users, call (866) 221-0268.

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

Location:

BARTOW, FL, US, 33830

Nearest Major Market:Lakeland