OPS ACCOUNTANT III

Requisition No: 824881

Agency: Department of Health

Working Title: OPS ACCOUNTANT III - 64950186

Pay Plan: Temp

Position Number: 64950186

Salary: $25.00 per hr

Posting Closing Date: 03/19/2024

Total Compensation Estimator Tool

Open Competitive Opportunity

Job Resbonsibilities:

• This is an OPS Accountant III position, in the Finance and Accounting program responsible for medical, dental billings and of Third-Party Insurances such as including but not limited to Medicaid and Medicare. Responsible to performed duties in accordance with all Federal, State and Local policies, procedures, regulations as related to the billing functions and operations of the Florida Department of Health Palm Beach County.
• Responsible to transmit claims electronically, track balance and control the re-submittal of denied claims and ultimately monitoring claims for final adjudication. Responsible to post payments to receivable accounts in the database, research, monitor and follow-up on discrepancies and re-submit claims to correctness and completeness of payments. Re-bills claims for payments not received. Posts routine voucher payments, monitors daily activity of the Electronic Data Information (EDI) report for transmission of claims assuring all Professional Claims have not been rejected upon transmission through the clearinghouse. Ensure payments are received within acceptable or contracted timeframes. Submit client statements according to policy. Responsible to review the Unbilled Listing report to ensure services billed have Current Procedure terminology (CPT), International Classification of Disease (ICD-10) diagnosis codes, correct policy ID number, modifiers, billing providers, and eligibility is correct with valid HMS 271 verification.
• Reports issues and consults with the supervisor to develop possible solutions to system generated problems. Gathers all information regarding third party payers for payment of claims. Calls or works through the miscellaneous website portals to verify denied or reason for denials.
• Works the Aged Receivable report monthly checking for payments not received from date of service. Appeals claims that should have been paid tracking the appeals. Require communicating with all third-party payers including Medicaid as needed to resolve denial/payments as necessary to resolve issues. Assist with eligibility lookup for incoming claims to assure correct billing party is billed.
• Runs remittance vouchers and other various reports from the HMS and balances various ledgers/spreadsheets of claim activity with reports from HMS to track outstanding resubmitted claims, denials processing and payments and assist clinical staff with corrections in HMS.
• Communicates with billing and clinical staff as needed to re-process denials in compliance with timely billing requirements and assure correct insurance information has been entered into the medical billing system. Responsible to post routine remittance vouchers in HMS.
• Answers phone calls related to client statements and resolves any billing errors.

• Incumbent may be required to work before, during and/or beyond normal work hour or days in the event of an emergency. Emergency duty required of the incumbent includes working in special needs 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.

• Performs other duties as assigned.

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:

800 Clematis Street,

West Palm Beach, FL 33401

The Benefits fo Working for the State of Florida:

Working for the State of Florida is more than a paycheck. As an OPS employee, the benefits below are available:

• State of Florida 401(a) FICA Alternative Plan (mandatory)
• Participation in state group insurance (upon meeting eligibility requirements. Consult with People First and/or the serving HR office)
• Workers’ Compensation (mandatory, if needed)
• Reemployment Assistance (Unemployment Compensation) (mandatory, if needed)
• Deferred Compensation (voluntary)
• Employee Assistance Program (voluntary)
• 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.

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

Applicants requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-877-562-7287). 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.

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.