SENIOR CLERK - 64082807

Requisition No: 884384 

Agency: Department of Health

Working Title: SENIOR CLERK - 64082807

 Pay Plan: Career Service

Position Number: 64082807 

Salary:  $34,760.00-$36,000.00 

Posting Closing Date: 10/06/2026 

Total Compensation Estimator Tool

Internal Agency

Your Specific Responsibilities:

This is highly responsible and independent position assisting the billing office and under the direct supervision of the Revenue Administrator I – SES with tasks and/or assignments for the Billing Department of the Office of Public Health Financial Management Division. This position maintains a variety of accounting and financial records for clients’ accounts, which include billing processes for third party reimbursement Ensures all claims are submitted in accordance with each vendor’s established policy and procedures. Have full knowledge of all medical benefit levels, fee schedule and cost-based reimbursement methodology and regulatory requirements for medical reimbursement. Maintains and respects the confidentiality of patient information in accordance with the County Health Department guidelines, the Miami-Dade County Health department policies & procedures, and HIPAA guidelines.

The incumbent is responsible for gathering all information regarding Medicaid HMO denials and follow-up on appeals process. Communicate payment or denial patterns to management that impact revenues in a timely manner. Works monthly reports to reconcile the payment report against the denial report to identify “No claims on file. Keeps statistical reports of claims monitoring and analyzing the tracking of the age receivable reports by classifying them by age ranges and pay source. Advises supervisor of all regulation changes reported by vendors that are learned while working denials to ensure compliance and prompt payment. Report to supervisor any coding changes affecting payment of claims.  Assist in posting checks to the HMS systems when necessary.

To perform this work, various reports from the Health Management System (HMS) Report Portal must be run monthly as follows: the pending report, the denial report and the charges and payments by payment source reports. In addition, Remittance Advice reports must be downloaded from different websites. FMMIS must be used to audit, research, monitor, and follow-up on Medicaid and HMO Medicaid denied and re­submitted claims. Works with clinical staff as necessary to re-process denials in compliance with timely billing requirements. Posts remittance vouchers to make sure recoupments of funds are recorded accurately. Verifies Medicaid Member eligibility to assure that the correct Insurance information has been added into the client account Insurance screen in HMS. Make corrections and re-bills. Accumulates errors by front line clerk and sends them for corrections daily. Reviews the client's information to ensure that tests performed have been properly coded in the HMS System and in accordance with Program guidelines. Verifies accuracy of billed data and corrects any errors coded in HMS.

Assist the Revenue administrator in the daily functions. Prepares meeting agendas presentations, takes meeting minutes and performs other duties assigned due to changes in the Billing office operations.  

Verities Medicaid, Medicare and private insurance coverage to submit claims to the corresponding entity. Using FMMIS or other Medicaid or Medicare verification system to identify eligible clients. Reviews claim data submitted on encounter forms for completeness and compliance with guidelines. Prepare encounter forms for all health units to request third party reimbursement for services rendered to patients. Post payments within 48 hours of receipt date. Re-processes denials within one week of receipt date. This involves working on sensitive confidential information pertaining to clients. Must use the HMS system to process all third parties billing.

Completes internal supply requisition forms, work orders, and tickets. Processes all incoming mail, including receiving medical encounters forms from the clinics.

Provides training for new employees in the department.  Upon each HMS release/update the incumbent is responsible to retrain users of the Medical HMS billing portion.  Creates cash draw set up for new employees on the HMS system.

Attends mandatory training as required.  Ensures accurate completion and timely submission of all administrative records including EARS, timesheets, mileage, FDENs, etc.  Performs other related work as required.  

Performs all other duties as assigned.

Required Knowledge, Skills, and Abilities:

Knowledge of ICD-10 diagnosis codes; know how to use codes for billing purposes.  Knowledge of Medicare and Medicaid coding guidelines.  Knowledge of Financial Information System (FIS) Knowledge of numbers, their operations, and interrelationships including one or more of the following:  arithmetic, algebra, geometry, calculus, statistics, and their applications. Knowledge of economic and accounting principles and practices, the financial markets, banking, and the analysis and reporting of financial data. Knowledge of principles and processes involved in business and organizational planning, coordination, and execution.  Knowledge of Medical Coding.  Knowledge of computer software including applications.

Qualifications:

Minimum-

Customer service experience, experience with billing processes.

Where You Will Work:

8175 NW 12th Street, Miami, Florida 33126

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.

The Benefits of Working for the State of Florida:

Working for the State of Florida is more than a paycheck. The State’s total compensation package for employees features a highly competitive set of employee benefits including:

• Annual and Sick Leave benefits;
• Nine paid holidays and one Personal Holiday each year;
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options;
• Retirement plan options, including employer contributions

(For more information, please click www.myfrs.com);

• Flexible Spending Accounts;
• Tuition waivers;
• 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.

All Florida Department of Health positions require the incumbent to be able to learn and communicate effectively, orally and in writing, in English. Applicants who do not meet this requirement will not be considered.  

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. 

Florida has the third largest population of veterans in the nation with more than 1.5 million service men and women.  The Florida Department of Health (department) is committed to serving members of the United States Armed Forces, veterans and their families by encouraging them to apply for vacancies that fit their area of knowledge and/or expertise.  Through the Department's VALOR program, which expedites licensing for military veterans, the Department also waives initial licensing and application fees for military veterans who apply for a health care professional license within 60 months of an honorable discharge. These initiatives help ensure that the transition from military service into the workforce is as smooth as possible and reflects our appreciation for the dedication devoted to protecting our country.    

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.

VETERANS’ PREFERENCE.  Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply.  Certain service members may be eligible to receive waivers for postsecondary educational requirements.  Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code.  Veterans’ Preference documentation requirements are available by clicking here.  All documentation is due by the close of the vacancy announcement.