Reimbursement Officer I

Under general supervision, performs a variety of professional reimbursement duties; investigates and evaluates the financial responsibility of individuals, their estates, and their legally responsible relatives to determine appropriate equitable schedules of charges for services. Prepares correspondence to collect funds; conducts personal interviews with the individual, their relatives, attorneys, insurance companies, etc. to acquire information and explain statutes, policies, and procedures relating to reimbursement programs to staff and individual families. Confers with supervisor concerning the more complex cases; maintains and reviews files, assists in training other staff in reimbursement operations. Serves as Medicare Part B Coordinator; reviews and approves account adjustments; prepares correspondence used to expedite the collection of funds; serves as liaison with officials handling probate and civil cases. Ensures compliance with applicable Public Health, Public Aid, facility department and state policies and procedures, as well as facility form guidelines.

Requires knowledge, skill and mental development equivalent to completion of four years of college, with courses in accounting, economics, or business administration, preferably including courses in insurance, estate and probate law. Requires one year of work experience in the reimbursement field. Requires working knowledge of the Federal Health Care Law as it pertains to recipients at State facilities. Requires extensive knowledge of the various; reimbursement forms utilized by the facility. Requires extensive knowledge of the statutes and departmental policies, rules and regulations as they relate to the reimbursement or monies to the State for the care and treatment of individuals. Requires extensive knowledge of mathematical calculations relevant to reimbursement funding. Requires extensive knowledge of the filing system used in the reimbursement program. Requires ability to analyze records, accounts, forms and legal documents to ascertain financial condition, completeness, accuracy and sufficiency in compliance with State laws and departmental rules and regulations. Requires ability to update and maintain complex reimbursement records. Requires ability to make varied mathematical calculations. Requires ability to prepare complex reports relevant to reimbursement operations.