Human Resources

Principal Medical Billing Clerk

DISTINGUISHING FEATURES OF THE CLASS: This is highly important work involved in medical billing, and the responsibility for planning and overseeing complex financial record keeping activities which may include independently performing the most important phases of such work.  The work may be performed on an alpha/numeric keyboard.  Work is performed under general supervision and in accordance with outlined policies and procedures but it calls for the frequent exercise of independent judgment.  Difficult technical or policy problems are referred to a supervisor for decision, or review of judgment where recommendations are initiated.  An employee in this position is responsible for insuring that medically related functions of the Department are carried out effectively.  Supervision may be exercised over lower level employees.  Does related work, as required.

Plans, assigns, and review the maintaining and checking of a wide variety of financial records and reports and instructs employees in the specialized details of this work;
Oversees and assists in the classification of a complex variety of receipts and expenditures and    the distribution of costs according to prescribed codes;
Directs the audit of varied financial records and claims and the preparation of reports thereon;
Compiles, prepares and analyses of a variety of complex financial and statistical records and reports;
Assists in the preparation of annual operating budgets and insures the maintenance of necessary financial controls;
Is responsible for the receipt and accounting of large amounts of money in payment for a variety of bills, taxes and related obligations;
Revises, systematizes and installs financial record keeping methods and procedures;
Reconciles ledgers of revenue received with bank statements;
May supervise the preparation of purchase orders and the securing of bids from vendors;
Conducts correspondence in connection with financial matters;
Confers with Medicaid/Medicare recipients regarding medically-related insurance problems;
Consult medical vendors (physicians, hospital administration, pharmacists, opticians, etc.) regarding Medicaid/Medicare allowable services;
Facilitates Medicaid/Medicare-coverable services and fee codes;
Consult with area Medical Director, Medical Care Administrator, State Fraud and Abuse representatives and various Auditors regarding the monitoring of Medicaid/Medicare expenditures;
Insures the implementation of Medicaid/Medicare regulations and rate changes through review and discussion with other members of the staff;
Acquires general knowledge of all Health Insurance plans available to Medicaid/ Medicare recipients, and the means to implement these resources to their fullest extent.

The above examples of duties are intended only as illustrations of the various types of work performed.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position.

FULL PERFORMANCE KNOWLEDGES, SKILLS, ABILITIES, AND/OR PERSONAL CHARACTERISTICS: Thorough knowledge of modern methods used in maintaining financial records; thorough knowledge of office terminology, procedures and equipment; thorough knowledge of Business English; good knowledge of Federal, State and local medical resources; good knowledge of the rules and regulations relating to medical services provided by the Social Services agency; ability to plan, assign and supervise the work of financial records keeping and clerical assistants; ability to understand and carry out complex oral and written directions; ability to make arithmetic computations rapidly and accurately; ability to prepare correspondence and reports; ability to secure the cooperation of others; ability to deal effectively with the public; ability to readily acquire familiarity with departmental organization, functions, laws, policies and regulations; good judgment in solving complex financial records keeping problems of the confidential nature of medical information concerning clients; full awareness of a high degree of accuracy, initiative and resourcefulness; tact and courtesy; integrity.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is frequently required to sit, use hands to finger, handle, or feel objects, tools, or controls; and reach with hands and arms.  The employee is occasionally required to walk, talk or hear.

The employee must occasionally lift and/or move up to 25 pounds.  Specific vision abilities required by this job include close vision and the ability to adjust focus.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually quiet.

MINIMUM QUALIFICATIONS: Graduation from high school or possession of an appropriate equivalency diploma recognized by the NYS Department of Education, AND EITHER:

  1. Possession of a Bachelor’s Degree, with a major in accounting;
  2. Possession of an Associate’s Degree, with a major in accounting AND two (2) years of full-time, paid experience in financial record  keeping duties, one (1) year of which shall have dealt with the processing of medical insurance accounts;
  3. Four (4) years of full-time, paid experience in financial record keeping duties, two (2) years of which shall have dealt with the processing of medical insurance accounts.