JOB TITLE: FACILITY REIMBURSEMENT TECHNICIAN

JOB CODE: 08600

SERIES NATURE OF WORK:

The Facility Reimbursement job series describes work in identifying and collecting financial reimbursements for costs related to providing care to individuals residing at state operated facilities.

DEFINITION:

This is technical work in investigating, identifying, and quantifying the financial resources of individuals residing at state operated facilities to assist in the determination of financial liability by a Facility Reimbursement Officer.

An employee in this job ascertains individuals’ finances and other assets that may become sources for home, health care, and related maintenance services cost reimbursements or may impact upon their health care benefits eligibility. Work involves identifying all benefits available to defray the costs of provided home and health care; gathering and compiling personal financial and asset information; and examining account payment histories for the purpose of initiating dunning procedures. Employees work independently under the supervision of a Facility Reimbursement Officer.

EXAMPLES OF WORK: (NOTE: The examples of work are representative of the work, but every position classified to this job may not perform all examples of work listed. Conversely, this is not an all-inclusive list of work examples.):

Interviews individuals and their relatives, friends, and benefits sources to gather personal financial information about residents including benefit and pension programs, insurance, or other assets.

Gathers, examines, evaluates, and re-evaluates information related to individuals’ available benefits programs including Social Security, Medicare, Medicaid, medical assistance programs, private insurance, and pensions.

Examines individuals’ benefits and other assets to calculate their liability to apply towards the cost of their home, healthcare, and related maintenance services.

Contacts trust officers and attorneys when patients have a trust or other assets to determine if assets are assessable.

Calculates per individual monthly home, health care, and related maintenance services costs and fees.

Examines courthouse records to document property holdings of individuals or their representative payees to determine or verify their property holdings.

Initiates action to revive liens of individuals and/or their liable representative payees.

Identifies excessive or unusual expenses and the circumstances relating to individuals’ income, assets, or liabilities.

Examines individuals’ payment histories and initiates dunning procedures on delinquent accounts.

Contacts individuals’ representative payees to ascertain the reason for and to rectify delinquent accounts.

Assists individuals with financial transactions including establishing bank accounts, bank account withdraws, and arranging for payments on debts and expenses.

Prepares documentation for delinquent account transfer to appropriate Commonwealth agency.

Develops correspondence and telephone strategies to support collection efforts.

Prepares a variety of reports including individuals’ finances and other assets, collection activities, and individuals’ financial status changes.

Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

Knowledge of the principles and practices utilized in financial billing and collection operations.

Knowledge of the principles and practices utilized in the maintenance of individual financial accounts.

Knowledge of basic mathematical calculations, such as addition, subtraction, multiplication, and division.

Ability to maintain effective working relationships.

Ability to communicate effectively orally.

Ability to communicate effectively in writing.

MINIMUM EXPERIENCE AND TRAINING: (NOTE: Based on the Entry Level Knowledges, Skills, and Abilities):

Three years of experience involving public contact work in the billing and collection of financial accounts or debts;

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An equivalent combination of experience and training. Completion of college-level work with major course work in business administration, finance, accounting, health care management, or a related field may be substituted for required experience on a year-for-year basis.