Job Description

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Under direct supervision of the Contracts and Operations Manager, serves as the supervisor of Case Services and the Hearing Program in the Children and Youth with Special Health Care Needs (CYSHCN) Section. Responsible for overall coordination of administrative and fiscal functions related to the review and processing of requests for reimbursement of services authorized under CYSHCN programs (Children's Rehabilitative Services (CRS), Orthodontia, Hearing and Sickle Cell) and monitoring requests submitted to the hearing program for accuracy and compliance with CYSHCN policies and procedures.
Provide daily oversight and technical assistance for the hearing program for both providers and CYSHCN staff. Monitor program service authorizations and daily operations to ensure accuracy and compliance with CYSHCN standards, policies, and procedures.
Review, reconcile, and monitor provider reimbursement requests and service authorizations. Ensure reimbursement requests are accurate, complete, and adhere to the CYSHCN financial policy and guidelines. Process reimbursement requests for CYSHCN payment programs and monitor case service operations. Research and troubleshoot issues or concerns regarding provider reimbursement requests for all CYSHCN payment programs.
Supervise Case Services billing and hearing staff.
Provide customer support and technical assistance to customers with billing-related or hearing program issues or concerns.
State Minimum Requirements: A high school diploma and relevant experience in business management, public administration or administrative services. A bachelor's degree may be substituted for required work experience.
Institutions of Higher Learning must be recognized by the Council for Higher Education Accreditation.
Agency Additional Requirements: Excellent organizational and leadership skills as well as strong customer service skills with the ability to deal with challenging situations or customers. Clear, concise and effective communication, both verbally and in writing. Ability to interpret and understand complex third-party benefits (i.e. explanation of benefits and invoices) and apply to program policies and procedures. Ability to coordinate and manage a large volume of invoices. Familiarity with Microsoft Office Suite (Word, Excel, PowerPoint, and Outlook) and other relevant data management software. Ability to interpret Current Procedural Terminology (CPT) codes and diagnosis codes. Ability to reconcile payments and ensure timely processing and submission to Accounts Payable. Strong attention to detail and the ability to maintain accurate records and client information. Ability to establish and maintain effective working relationships. Ability to plan, organize and supervise direct reports.
Applicants indicating college credit or degree(s) on the application may upload an unofficial copy of the transcript as an attachment to the application. Please note that the agency will require an official, certified copy of the transcript or diploma prior to hiring.
Experience and knowledge of governmental fiscal procedures, practices, and policies. At least three (3) years of clinical billing experience, to include medical billing and/or coding, or relevant experience in medical billing.
EEO: The Department of Public Health is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth, or related medical conditions including, but not limited, to lactation), national origin, age (40 or older), disability, or genetic information.
REASONABLE ACCOMMODATION: Applicants needing accommodation for medical reasons or a sincerely held religious belief may submit a request for accommodation. A reasonable accommodation may be granted if it doesn't impose an undue hardship or pose a direct threat to the health and safety of others.
STATE DISASTER PLAN: In accordance with the State's Disaster Plan, which includes hazardous weather, Department of Public Health employees may be required to work in times of an emergency or disaster.
DRIVING RECORD: If this position requires the applicant to possess a valid driver's license to operate a state vehicle or personal vehicle, any applicant, being considered in the final stages of selection for the position will be required to provide a certified copy of a 10-year driving record.
The South Carolina Department of Public Health offers an exceptional benefits package for Temporary Grant positions that includes:

• 15 days Annual (Vacation) Leave per year
• 15 days Sick Leave per year
• 13 Paid Holidays
• Paid Parental Leave
• Health, dental, vision, long-term disability, and life insurance for employees, spouse, and children. Click

for additional information. * S.C. Deferred Compensation Program available

• Retirement benefit choices *

• State Retirement Plan
• State Optional Retirement Program

*Enrollment in one of the listed plans is required for all Temporary Grant employees; please refer to the contribution section of hyperlinked retirement sites for the current contribution rate of gross pay.
HYBRID WORK: The option to work partially remote or adjusted work hours may be available after 12 months of employment for approved positions.

Skills Required