4. 1st Addendum 02/21/2024 GVS COURTq c
o: A Kevin Madok, CPA
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�o ........ � Clerk of the Circuit Court& Comptroller Monroe County, Florida
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DATE: February 23, 2024
TO: Cheri Tamborski
Emergency Services
Mayor Bruce Halle
Fire & Ambulance District 1 Board of Governors
FROM: Liz Yongue, Deputy Clerk
SUBJECT: February 21, 2024 BOCC Meeting
The following item has been executed and added to the record:
C10/H1 1st Addendum to Employment Agreement with Nina Burgess for Fire Rescue
EMS Billing Specialist position with an increase in annual salary from $52,000 to $57,200 to
commence on February 19, 2024 and terminate on February 18, 2026.
Should you have any questions, please feel free to contact me at(305) 292-3550.
cc: County Attorney_
Finance
File
KEY WEST MARATHON PLANTATION KEY
500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway
Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070
FIRST ADDENDUM TO EMPLOYMENT AGREEMENT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS,
THE BOARD OF GOVERNORS OF MONROE COUNTY
FIRE & AMBULANCE DISTRICT I,AND
NINA BURGESS
FOR THE POSITION OF EMS BILLING SPECIALIST
THIS FIRST ADDENDUM TO EMPLOYMENT AGREEMENT ("Addendum") is
entered into upon the date below written by and between Monroe County, Florida, acting through
its Board of County Commissioners ("BOCC"), a political subdivision of the State of Florida,
whose main business address is 1100 Simonton Street, Key West, Florida 33040; the Board of
Governors of Monroe County Fire & Ambulance District 1 (collectively "County") and Nina
Burgess ("Employee").
WHEREAS, the County entered into an Employment Agreement ("Agreement") with
Nina Burgess on March 19, 2022 for a period of twenty-four(24) months for the position of EMS
Billing Specialist which is due to expire on February 18, 2024; and
WHEREAS, the Employment Agreement allows the parties to extend the employment
term by written addendum; and
WHEREAS, the Employee has satisfactorily performed her duties therefore the parties
desire to update several terms and extend the term of the contract for a period of two years,
becoming effective on February 19, 2024 and terminating February 18, 2026, subject to
modification of certain other terms within the Agreement; and
NOW THEREFORE, in consideration of the mutual promises contained herein, the
County and Employee set forth herein, it is mutually agreed as follows:
1. Paragraph 2(c) of the Agreement is amended to read as follows: At the discretion of
the EMS Billing Supervisor, Employee may be required to be physically present at the
Billing Specialist Employment Agreement
(Nina Burgess) Page 1 of 3
EMS Billing Office located at 490 63`d Street, Marathon, FL 33050 for a minimum of
forty (40) hours per week.
2. Paragraph 3(a) of the Agreement is amended to read as follows: In return for
performance of the duties set forth in Exhibit A, including but not limited to specific
duties assigned by MCFR from time to time, Employee shall receive an annual salary
in the amount of fifty-seven thousand and two hundred dollars ($57,200).
3. Paragraph 3(d)(i) is amended to read as follows: Employee agrees to obtain EMS
Ambulance Billing and Coding Certification while employed by Monroe County as an
EMS Billing Specialist and during the term of this Agreement. Tuition costs related to
the certification are eligible for reimbursement by Monroe County Fire Rescue of the
actual expenditure in accordance with Section 2.11 of the Monroe County Personnel
Policies and Procedures Manual("Manual"),including the condition that the Employee
must reimburse the cost of tuition if Employee terminates from Monroe County within
one(1)year of completion of the course.
4. Paragraph 4 is amended to read as follows: The Employee agrees to abide by Section
1.03 OUTSIDE EMPLOYMENT as set forth in the Manual, and any updates thereto.
5. Paragraph 5(a) is amended to read as follows: The normal term of this Agreement as
extended by this Addendum will be for a period of twenty-four (24) months
commencing February 19, 2024 and terminating on February 18, 2026.
(signatures on next page)
Billing Specialist Employment Agreement
(Nina Burgess) Page 2 of 3
IN WITNESS WHEREOF,the parties have set their hands and seals, in the County of
Monroe,Florida this 21st day of February , 2024.
MONROE COUNTY FIRE RESCUE
By..a/a4p/S1P
James Callahan, Fire Chief
WITNESS: EMPLOYEE
By: B3:_0:,..„/ 4 ti .0
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41 Nina Burgess
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.71%,,, ,AGATTEA KEVIN MADOK,CLERK COMMISSIONERS
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Mayor
MONROE COUNTY ATTORNEY BOARD OF GOVERNORS OF FIRE
Approved as to form and content: AND AMBULANCE DISTRICT 1 OF
MONROE COUNTY,FLORIDA
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By: By: jrCe--
Assistant County Att rney Mayor/Chairperson
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Billing Specialist Employment Agreement
(Nina Burgess) Page 3 of 3
0� MONROE COUNTY
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' FLORIDA
Job Description
To perform this job successfully, an individual must be able to perform the essential job functions
satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform
the primary job functions herein described. Since every duty associated with this position may not be
described herein, employees may be required to perform duties not specifically spelled out in the job
description,but which may be reasonably considered to be incidental in the performing of their duties just
as though they were actually written out in this job description.
Job Title- EMS Billing & Claims Specialist, Fire Rescue
Department: Monroe County Fire Rescue
Pay Grade: Contract
FLSA Status: Non-exempt
JOB SUMMARY
The primary function of this position is to be responsible for report review, data entry, retrieval,
and records maintenance of an air and ground EMS billing program; and for performing
complex administrative work within the division of Emergency Services.
ESSENTIAL JOB FUNCTIONS
• Reviews ePCR reports to ensure complete and accurate patient demographic,trip,
billing, and insurance information; refers incomplete or inaccurate records to EMS
Quality Assurance.
• Extensive knowledge of medical terminology, CPT, WCPCS, ICD 10, and CMS 1500
Revenue Codes, modifiers, billing, rules, and recommendations for government and
commercial payers.
• Verifies or assigns condition codes, modifiers, levels of service, and other relevant claim
data.
• Scans and attaches biomedical and supporting trip records to electronic patient care
reports.
EMS Billing&Claims Specialist,Fire Rescue Page 2
• Greets customers in person and by telephone, receives account payments, and assists
customers as necessary in the completion of insurance forms,Air Resident (Trauma
Star) waivers, and records requests.
• Initiates pre-authorization for air ambulance transportation, if applicable for specific
insurances.
• Assists Billing and Claims Supervisor with collection actions, including contacting
patients by phone and arranging payments.
• Minimizes the number of aging accounts to maintain a consistent workflow by regularly
following up on unpaid claims.
• Processes and posts Medicare, Medicaid,Automated Clearing House (ACH) payments,
wire transfers,checks, and credit cards payments on a daily basis. Reviews and
processes refunds as needed.
• Reviews and follows up on accounts before transferring to an outside collection agency
that have reached collections timeframe for accuracy.
• Processes Air Resident(Trauma Star)waivers.
• Processes legal records requests for patient care reports and response records.
• Performs monthly EMSTARS extract and data submission to Department of Health, State
EMS Division to comply with mandatory pre-hospital reporting requirements.
• Reviews, processes, and responds to correspondence accordingly.
• Posts payments and denials accurately.
• Maintains several spreadsheets for billing reconciliation.
• Scans and maintains accurate day to day posting documents and correspondence in One
Drive for audits and compliance purposes.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations and
County/Department Policies and Procedures.
• Needs to stay informed of regulatory changes with the ability to adapt and navigate the
claim reimbursement and denials environment.
• Possess strong written communication and grammar competencies to generate appeal
letters that are specifically tailored to the patient's level of illness,the quality of service,
reason for denial,and capacity against which prompted denial.
• Processes RFPs, contracts, renewals, purchases,agenda items, special projects, and
maintains records.
• Participates in any meetings, phone conferences,or webinars that may be required to
process rejections effectively, acquire information about the appeals process, adapt to
the latest regulations and laws, or comprehend the terms of payer contracts.
• Assists in budget preparation and monitoring expenses.
• Performs other related job duties as assigned.
• In the event of special, emergency, or disaster situations, employee may be required to
work schedules other than those for which they are regularly scheduled in any capacity
deemed appropriate.
Monroe County,FL Fire Rescue Updated:O1/16/2024
EMS Billing&Claims Specialist,Fire Rescue Page 3
QUALIFICATIONS
Education and Experience:
High school Diploma or GED required. 3 years minimum of prior related work experience
preferred.
Special Qualifications:
Certified Ambulance Coder within one year of employment.
Knowledge,Skills, and Abilities:
• Ability to work from a general outline of duties and responsibilities.
• Ability to perform entry-level professional work including basic data analysis and
synthesis, report creation, process performance, and regulatory or compliance activities.
• Ability to follow basic guidelines for operational activities.
• Ability to work with less than ten co-workers who are mostly engaged in the same
activities as me.
PHYSICAL DEMANDS
The work is sedentary and requires exerting up to 10 pounds of force occasionally and/or
negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move
objects, including the Duman body.Additionally,the following physical abilities are required:
• Manual Dexterity: Picking, pinching,typing, or otherwise working, primarily with fingers
rather than with the whole hand as in Dandling.
• Mental Acuity:Ability to make rational decisions through sound logic and deductive
processes.
• Repetitive Motion: Substantial movements(motions) of the wrist, hands, and/or fingers.
• Speaking: Expressing or exchanging ideas by means of the spoken word including the
ability to convey detailed or important spoken instructions to other workers accurately
and concisely.
• Talking: Expressing or exchanging ideas by means of the spoken word including those
activities in which they must convey detailed or important spoken instructions to other
workers accurately, loudly, or quickly.
• Visual Acuity: Have close visual acuity to perform an activity such as: preparing and
analyzing data and figures;transcribing; viewing a computer terminal; and/or extensive
reading.
• Walking: Moving about on foot to accomplish tasks, particularly for long distances or
moving from one work site to another.
WORK ENVIRONMENT
Work is performed in a dynamic environment that requires sensitivity and responsiveness to
changes that include goals, priorities, and needs of the organization and position.
Monroe County,FL Fire Rescue Updated:O1/16/2024
EMS Billing&Claims Specialist,Fire Rescue page 4
Monroe County has the right to revise this job description at any time.
This description does not represent In any way a contract of employment.
*mploySignature Date
DigitaAy s�nad by James K.
James K. Callahan Ca11shen
Date:2024,01.19 11.34.14-0S
Supervisor or Director Signature Date
Bryan CookOate: y signed 2 Bryan t-06
Date:2024.01.22 12:39:12-05'00°
Director of Employee Services Signature Date
F.D.F. Monroe County does not discriminate on the basis of race, color, national origin, gender, religion, age,
disability or military service in employment or the provision of services.
Monroe County,FL Fire Rescue Updated:01/16/2024