Rep Payee Specialist

Do you enjoy making a difference in the lives of others?

IF YES... YOU NEED TO JOIN THE NHIA TEAM TODAY

New Horizons in Autism, Inc (NHIA) is a non-profit organization dedicated to providing diverse opportunities to enhance the quality of life for adults with autism since 1980 throughout Bergen, Monmouth, and Ocean Counties.

Title: Representative Payee Specialist

Qualifications/Education: Associates degree in Accounting/Financial Management preferred, Minimum High school Diploma, Medicaid Billing Certificate

Experience:

• Experience with Therap and Fee for Service Billing and Record Keeping.
• 2-5 years Medical Billing/Collections/Accounting experience in a corporate office environment.

Requirements: Employment is contingent on clearing the state required criminal background check, central registry, child abuse registry and drug testing.

Position Overview: This position reports directly to the Director of Billing. The Representative Payee Specialist handles billing of payer claims (primary, secondary, and tertiary) according to contract terms to include Medicaid guidelines.

Personal Characteristics:

1. Must be able to multi-task.
2. Must demonstrate the ability to follow through with tasks at hand.
3. Must demonstrate the ability to communicate and participate in a team environment.
4. Must be able to work under adverse conditions.
5. Must exercise common sense and good judgment.
6. Ability to maintain appropriate relationships with people with disabilities and at-risk adolescents utilizing normalization principles.
7. Ability to interact effectively with all levels of staff, Families, and within the community.
8. Ability to express oneself, both in writing and verbally, in comprehensive manner, using the English Language
9. Good planning and organization skills. Working knowledge of computer software programs including Microsoft Office products. Ability to be resourceful and work independently and problem solve.
10. Ability to perform basic mathematical functions.
11. Ability to deliver effective presentations and &train programs.
12. Demonstrate responsible leadership, mentoring and role-modeling.
13. Access to an automobile vehicle, valid driver’s license and safe driving record required

Examples of Duties Performed:

• The Representative Payee Specialist is responsible for the billing of all payer claims.
• This position runs assigned daily billing reports to determine account needs and updates files with current billing information.

Primary Responsibilities:

1. Responsible for maintaining files for all individuals in the Rep Payee Program.
2. Responsible for maintaining needed Social Security Authorizations.
3. Responsible for maintaining individual debit cards.
4. Responsible for maintaining and conducting all SSA needed appointments.
5. Responsible for maintaining and completing all SSA needed paperwork.
6. Reconcile individual debit cards on a monthly basis.
7. Maintain individual Medicaid eligibility.
8. Work effectively with agency staff.
9. Bill pay for the individuals of NHIA Rep Payee Program.
10. Reporting to the Social Security Administration.
11. Submit timely claims to commercial and non-commercial payers
12. Maintain accurate records of all billings.
13. Submit accurate and timely reports as needed.
14. Reviews and confirms that appropriate billing documentation has been obtained.
15. Maintains knowledge of Medicaid guidelines and applies that knowledge to billing as required by individual contracts.
16. Understands Medicaid, Medicare, and Insurance billing, including coordination of benefits.
17. Monitors electronic transmission of claims to avoid delay in processing of E-bill file to clearinghouse. Check and balance all claims were loaded and file was received.
18. Identifies, monitors, and corrects rejected electronic and paper claims.
19. Maintain accuracy of reference materials and implement new billing codes and fee schedules.
20. Verifies data entry to ensure accuracy of imported/keyed data.
21. Works unbilled revenue reports to verify pending claims and bring them closure.
22. Reconciles open accounts to clearly establish patient responsibility.
23. Performs other Finance or Accounting related tasks as assigned by supervisor.
24. Must be attentive to detail and be able to multi-task between projects.
25. To be aware of and practice agency philosophy and agency policies and procedures during the course of supporting all of the organizations business endeavors.
26. Exercise due diligence in concert with the Director of Finance to prevent and detect misconduct and wrongdoing. Undertake all reasonable steps to respond appropriately when an offense is detected to prevent future or similar offenses.
27. To assist all service recipients under the guidance of New Horizons in Autism, Inc. in daily living.
28. To perform any other job-related duties.
29. At all times, to maintain the confidentiality of all of the organizations business dealings under the guidance of New Horizons in Autism, Inc.
30. At all times, to adhere to the organizations. Policies and procedures.
31. At all times, to act in a professional manner.
32. At all times, work to promote a positive and service-oriented atmosphere among employees and other colleagues.
33. At all times, act as an exemplary representative of the organization.
34. At all times, adhere to the organizations code of ethics.
35. Attends and participates in administrative meetings.
36. The Representative Payee Specialist will demonstrate the ability to be a team player through cooperation and communication with co-workers, supervisors, service recipients, school districts and outside contacts.
37. The Representative Payee Specialist will adhere to the attendance policy. When the staff member is going to be late or tardy they must contact their immediate supervisor. This contact cannot be done via the voicemail system they must speak directly to a supervisor.
38. Must assure that the facility requirements for building maintenance and program security are followed.
39. Performs quality assurance checks, or any additional measures of quality.
40. Initiates, incorporates and participates in making improvement to one’s job or department either individually or in-group efforts.
41. All staff must adhere to the protocols established in regard to preventing violence in the workplace written policy.

Job Related Behaviors:

1. Ability to maintain appropriate relationships with people with disabilities and at-risk adolescents utilizing normalization principles.
2. Ability to interact effectively with all levels of staff, Families, and within the community.
3. Ability to express oneself, both in writing and verbally, in comprehensive manner, using the English Language.
4. Good planning and organization skills.
5. Demonstrate responsible leadership, mentoring and role-modeling.
6. Working knowledge of computer software programs including Microsoft Office products. Ability to be resourceful and work independently and problem solve.
7. Ability to deliver effective presentations and train programs.
8. Access to an automobile vehicle, valid driver’s license and safe driving record required.

All NHIA staff will be required to cooperate with the licensee, Department of Human Service (DHS) staff in any inspection or investigation. All NHIA staff must also work in collaboration with NHIA’s fact-finding internal investigators.

*Please note that these requirements listed in this job description are representative, but not all-inclusive, of the knowledge, skill, and ability required to perform this job. Reasonable accommodations may be made to enable Directs with disabilities to perform the essential functions.