Title
Human Resources Department and Chief Administrative Office recommending the Board consider the following:
1) Adopt and authorize the Chair to sign Resolution 180-2019 to accomplish the following:
a) Establish the job classification specification, salary range, and bargaining unit for the new classification of Medical Billing Technician;
b) Amend the Personnel Allocation to add 1.0 FTE Medical Billing Technician position and 1.0 FTE Administrative Analyst I/II position in the Chief Administrative Office; and
c) Abolish the Sr. Medical Billing Assistant and Medical Billing Supervisor classifications.
2) Authorize the establishment of a new org code in the EMS and Emergency Preparedness Division for Ambulance Billing;
3) Approve a budget transfer increasing revenues and appropriations in the new Ambulance Billing org. (4/5 vote required to approve budget transfer)
FUNDING: Ambulance Billing Revenue in County Service Areas 3 and 7.
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DISCUSSION / BACKGROUND
Effective July 1, 2019, the Emergency Medical Services and Emergency Preparedness & Response (EMS-EP) programs were transferred from the Health and Human Services Agency (HHSA) to the Chief Administrative Office (CAO). At that time, the Ambulance Billing function remained with HHSA. After the program transfer, staff has evaluated the placement of the Ambulance Billing function. The evaluation determined that it would be more efficient to transfer the Ambulance Billing function to the CAO’s office where the program and fiscal components would be centralized. At the Board of Supervisors August 27th meeting, the Board conceptually approved the transfer of the Ambulance Billing function from HHSA to the CAO’s office, which also noted that the CAO’s office would return to the Board with an amendment to the personnel allocation.
CAO staff have met with HHSA staff to develop a plan to transition to the new billing vendor. CAO staff are currently negotiating a contract with Wittman Enterprises to take over billing as of January 1, 2020. HHSA staff will continue to coordinate with the current biller and to provide ambulance billing services for all dates of service through December 31, 2019. In addition, HHSA will continue to work with the current biller through the end of its contract on June 30, 2020, to resolve outstanding accounts. As a result, it is necessary to add staff to the Chief Administrative Office to facilitate the transition to the new vendor and maintain staff in HHSA to phase out the old vendor. The function will fully transition no later than June 30, 2020, and HHSA will delete two allocations during the FY 2020-21 budget process. Funding for ambulance billing staff is provided by County Service Area 3 and 7.
The proposed agreement with the new billing vendor, Wittman Enterprises includes all services currently provided by the current vendor, along with other services currently not being provided. As a result, the main duties associated with the fiscal component of the Ambulance Billing function will involve duties such as reconciliation of accounts; contract maintenance, interpretation and review of contract terms and performance; report writing; and analysis of collection rates. The duties and responsibilities of this position are consistent with the Administrative Analyst classification.
In addition, it was determined that the Ambulance Billing function requires a position which performs specialized medical billing work requiring advanced knowledge of insurance and program requirements; medical billing codes and procedures, including auditing of medical bills and payments and maintaining complex and detailed records utilizing an electronic medical records system. As such, the Manager of EMS-EP worked with Human Resources to develop a classification that would encompass the knowledge and skills required of the position, resulting in the new department specific classification of Medical Billing Technician. Human Resources conducted an internal compensation study in order to establish a current salary range for the Board’s consideration.
Due to the proposed actions above, the County no longer requires the use of the Sr. Medical Billing Assistant and the Medical Billing Supervisor classifications; therefore, Human Resources is recommending these classifications be abolished.
ALTERNATIVES
The Board could choose not to adopt and approve any of the recommendations listed herein and request that revisions be made.
PRIOR BOARD ACTION
8/27/2019 Legistar Item 19-1241
OTHER DEPARTMENT / AGENCY INVOLVEMENT
Health and Human Services Agency
CAO RECOMMENDATION
It is recommended the Board approve this item.
FINANCIAL IMPACT
There is no financial impact related to establishing the Medical Billing Technician class specification.
Funding for these positions will be from the EMS special revenue fund. The approximate annual cost of the Medical Billing Technician is $83,700 and the Administrative Analyst I/II position is $102,290. The total approximate cost of the two positions is $186,000 a year. As the new positions will not result in the deletion of the current positions for at most 7 months, the estimated costs for the remainder of FY 2019-20 are $110,371, as reflected in the attached draft budget transfer.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Upon Board adoption and approval, please provide a fully executed copy of the Resolution to Katie Lee in Human Resources. Once the new org code has been established, the CAO Fiscal Unit will prepare a final budget transfer for execution by the Chair.
STRATEGIC PLAN COMPONENT
Good Governance
CONTACT
Tameka Usher, Director of Human Resources
Sue Hennike, Deputy Chief Administrative Officer