- Reimbursement Officer I
- What will I be doing?
- Do I qualify?
- Can I be successful?
- How do I apply?
This is entry-level technical investigation work determining the financial resources of recipients of health and mental health services to obtain reimbursement for the cost of care and treatment.
Interviews recipients and/or financially responsible persons to gather information concerning available resources for payment of care and treatment and obtain reimbursement for the State.
Determines financial eligibility for commencement and/or continuation of services under federal entitlement programs.
Determines the amount to be charged for a recipient's care and treatment based upon investigational findings and by application of a means test.
Administers a facility reimbursement program of limited scope and complexity.
Conducts interviews, obtains information for completion of financial questionnaires, and determines amounts to be charged for care and treatment.
Serves as liaison with representatives of the Social Security Administration, Veterans Administration, and other federal, state, local government, and private agencies to obtain and maximize reimbursements.
Communicates with recipients' relatives, employers, financial institutions, insurance companies, and other persons or organizations to gather information concerning financial resources available to recipients which may be applied to their cost of care, treatment, and personal needs.
Supervises clerical staff involved in preparing entitlement and insurance applications, obtaining written consents, and gathering preliminary data for determination of ability to pay.
Obtains written consent and authorization for the release of information; obtains insurance and governmental assignments of benefits; reviews public documents and records.
Explains billing procedures and purpose of the reimbursement program to recipients and financially responsible persons.
Prepares reports of investigations and findings.
Responds to inquiries relating to payment for hospitalization or other services.
Exercises some discretion and independent judgment in decision making within the limits of established policies, directives, and regulations.
Performs other related work as assigned.
(The following minimum qualifications will determine merit system eligibility and may be used to evaluate applicants for Missouri Uniform Classification and Pay System positions not requiring selection from merit registers.)
A Bachelor’s degree from an accredited college or university with a minimum of 15 earned credit hours in one or a combination of the following: Public or Business Administration, Accounting, Economics, or a closely related field.
Four or more years of clerical experience in one or a combination of the following: health services billing, financial investigation, public or private health insurance claim filing, or a closely related area; and possession of a high school diploma or proof of high school equivalency.
Please note that documentation that supports your eligibility (i.e. transcripts, employment records, etc.) may be required at any time during the application and hiring process. If you do not possess the minimum qualifications, please consider one of many other employment opportunities with the State of Missouri.
Do you possess the key skills which are considered essential for successful employment in this classification?
Introductory knowledge of regulations and policies pertaining to reimbursement functions.
Introductory knowledge of regulations pertaining to benefits available to recipients through the Social Security Administration, Veterans Administration, and public and private health insurance.
Introductory knowledge of the methods used in conducting financial interviews and investigations.
Introductory knowledge of accounting and/or bookkeeping procedures and billing activities.
Introductory knowledge of probate court records relating to the evaluation of available resources.
Ability to comprehend, interpret, and explain policies, rules, regulations, procedures, and requirements pertaining to the reimbursement program.
Ability to compile clear and concise reports.
Ability to obtain facts by personal contacts and interviews, and by reviewing official records and documents.
Ability to establish and maintain effective working relationships with other employees, agencies, and the general public.
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