Item C21 C21
BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE i Mayor Holly Merrill Raschein,District 5
The Florida Keys Mayor Pro Tern James K.Scholl,District 3
Craig Cates,District 1
Michelle Lincoln,District 2
' David Rice,District 4
Board of County Commissioners Meeting
July 17, 2024
Agenda Item Number: C21
2023-2623
BULK ITEM: Yes DEPARTMENT: Fire Rescue
TIME APPROXIMATE: STAFF CONTACT: James K. Callahan
N/A
AGENDA ITEM WORDING:
Ratification by the BOCC of an Employment Agreement with Leah Fennessey hired to fill a vacancy as
a Monroe County Fire Rescue (MCFR) EMS Billing Specialist with an annual salary of $55,000,
commencing on June 24, 2024 and expiring on June 23, 2026; and authorizing the County
Administrator/Fire Chief to execute all necessary documents. Ratification by the BOCC is also being
requested for execution of an Addendum to Employment Agreement with Sandy Roussin for an equity
adjustment in annual salary from $52,000 to $57,000, commencing on June 24, 2024 and expiring on
June 23, 2026; and authorizing the County Administrator/Fire Chief to execute all necessary
documents.
ITEM BACKGROUND:
The MCFR EMS Billing Specialist position needs to be filled due to a vacancy by one of the EMS
Billing Specialists and MCFR desires to provide the existing EMS Billing Specialist with an equity
adjustment in annual salary as she has held that position for over three (3) years and has substantial
medical billing experience.
PREVIOUS RELEVANT BOCC ACTION:
06/21/23: BOCC and BOG approved a First Addendum to Employment Agreement with Dixie "Sandy"
Roussin for EMS Billing Specialist position.
08/18/21: BOCC and BOG approved an Employment Agreement with Dixie "Sandy" Roussin to fill a
vacant Fire Rescue EMS Billing Specialist position.
06/21/17: BOCC and BOG approved the Employment Agreement for one additional Billing Specialist.
02/15/17: BOCC and BOG approved creating a second EMS Billing Specialist position as a Monroe
County contract employee.
922
INSURANCE REQUIRED:
No
CONTRACT/AGREEMENT CHANGES:
Employment Agreement for Leah Fennessey and Second Addendum to Employment Agreement for
Sandy Roussin to commence on June 24, 2024 and expire on June 23, 2026.
STAFF RECOMMENDATION: Approve
DOCUMENTATION:
Employment Agreement for Leah Fennessey- Expires 06.23.2026 Signed Version.pdf
Roussin, Dixie Sandy- Expires 7-11-2023.pdf
Roussin, Dixie Sandy- C21 and H I Expires 7-11-2025.pdf
Addendum to Employment Agreement for Sandy Roussin Expires 06.23.2026.pdf
FINANCIAL IMPACT:
Annual Salary For Leah Hennessey: Total $55,000
• 101-11001 Medical Air Transport 78% $42,900
• 141-11500 Fire & Rescue Center 22% $12,100
Annual Salary For Sandy Roussin: Total $57,000
• 101-11001 Medical Air Transport 78% $44,460
• 141-11500 Fire & Rescue Center 22% $12,540
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EMPLOYMENT AGREEMENT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS;
THE BOARD OF GOVERNORS OF MONROE COUNTY
FIRE &AMBULANCE DISTRICT 1,AND
SICONG "LEAH"FENNESSEY
FOR THE POSITION OF EMS BILLING SPECIALIST
THIS AGREEMENT is entered into upon the date last 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 Sicong"Leah"Fennessey ("Employee").
WHEREAS,the position of EMS Billing Specialist is currently open, and
WHEREAS, the County has conducted an internal and external applicant search to fill the
open position and has selected Sicong "Leah"Fennessey to fill the position; and
WHEREAS, the parties desire to enter into a contract to become effective on June 24,
2024.
NOW THEREFORE, in consideration of the mutual promises contained herein, the
County and Employee set forth herein, it is mutually agreed as follows:
1. EMPLOYMENT: Employee is hereby employed as the EMS Billing Specialist as a
Contract Employee as that term is defined in Section 2.03 of the Personnel Policies& Procedures
Manual ("Manual").
2. DUTIES: Duties of the Employee will be as set forth in the Job Description attached
hereto as Exhibit A,the provisions of which are incorporated herein by reference.
A. The Employee shall not disclose to any person, party, or entity any confidential,
proprietary, time-sensitive, or non-public (including HIPAA) information relating to the
County or its operations unless required by law to do so.
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B. Upon termination of this Agreement,the Employee agrees to immediately surrender
all documents,information,property and assets to Monroe County Fire Rescue("MCFR").
C. At the discretion of the EMS Billing Supervisor, Employee may be required to be
physically present at the EMS Billing Office located at 490 63rd Street, Marathon, FL
33050 for a minimum of forty(40)hours per week.
3. COMPENSATION AND BENEFITS: County and Employee agree that the position
of EMS Billing Specialist will be a full-time position deemed non-exempt under the Fair Labor
Standards Act. Work hours performed, annual leave,personal leave, and sick leave hours taken
will be documented on a form or forms to be provided by the County,or by another method as
designated by the County.
A. Base Pay: In return for performance of the duties set forth in Exhibit A, including
but not limited to specific 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$55,000.
B. Financial Incentive: In lieu of any annual merit or cost-of-living adjustment, the
Employee will be eligible for a financial lump sum incentive based upon billing and
collections performance. After the conclusion of each billing and collections performance
review period, a comparison of EMS user fee revenue will be conducted to determine
whether a supplemental lump-sum payment is warranted for increased revenue receipts„
not to exceed ten percent (10%) of base salary.
C. Benefits: Except as otherwise set forth herein,the Employee shall also receive all
benefits set forth in the Monroe County Personnel Policies & Procedures Manual
("Manual")as said Manual may be amended from time to time.
D. Transportation and Business Related Travel: Employee agrees that she will be
responsible for providing her own motor vehicle for transportation. MCFR agrees to
budget and pay for the costs incurred by the Employee in attending approved seminar and
continuing education courses as may be deemed necessary or appropriate to employee's
duties and responsibilities under this Agreement and in accordance with County policy.
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i. Employee agrees to obtain EMS Ambulance Billing and Coding Certification
within 12 months of the execution of this agreement and 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 MCFR of the actual expenditure in accordance with Section
2.11 of the Monroe County Personnel Policies and Procedures Manual
C"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. SOLE EMPLOYMENT: The Employee agrees to abide by Section 1.03 OUTSIDE
EMPLOYMENT as set forth in the Manual, and any updates thereto.
5. TERM OF AGREEMENT,TERMINATION; CANCELLATION; GENERAL
RELEASE:
A. Normal Term. The normal term of this Agreement will be a period of twenty-four
(24) months commencing June 24, 2024 and terminating on June 23, 2026.
B. Extension of Time. The parties may extend the term of Agreement by written
addendum to this Agreement.
C. Termination of Agreement:
i. In entering into this Agreement, the Employee understands that she serves at
the pleasure of MCFR; and that the Employee can be terminated at any time
upon thirty (30)days written notice by MCFR without cause.
ii. In entering into this Agreement, the Employee also understands that she can
be terminated at any time upon 24 hours written notice by MCFR for cause.
As used in this paragraph,the term "for cause" will mean (a)dishonesty with
respect to the business and operation of the County; (b)confirmed violation of
the County's drug policy; (c)refusal to cooperate in an investigation regarding
any aspect of the business or operation of the County,including but not limited
to an investigation which is conducted by or at the express direction of the
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BOCC; (d) conviction of a crime which is classified as a felony or a crime
involving moral turpitude; (e) gross neglect or willful and intentional
misconduct; (f) conviction of a crime; (g) violation of a provision of the
Monroe County Code; or(h) breach of any material term or condition of this
Agreement by the Employee.
iii. The Employee further understands that in the event of termination, the
Employee is free to apply to the County for any other position then currently
open and the County is free to consider the Employee for any open position,
but that County has no obligation to place the Employee in another position,
and specifically has no obligation to place the Employee in a position of
equivalent or comparable salary, grade, or benefits. In entering into this
Agreement,the Employee therefore specifically waives the right to utilize the
grievance procedure set forth in Sections 9 and 10 of the Manual; House Bill
No. 2658, Chapter 69-1321, the Monroe County Career Service Council; as
well as any rights to which a Monroe County employee would otherwise be
entitled under Chapter 447, Florida Statutes.
iv. Resignation. In the event the Employee resigns from the position prior to the
normal expiration date of this Agreement,the Employee shall be entitled only
to payment for salary through the effective date of the resignation and any
v. accrued annual and sick leave in accordance the Monroe County Personnel
Policies and Procedures.
6. ATTORNEY'S FEES AND COSTS: In the event of any litigation initiated by either
party,the prevailing party shall receive reasonable attomeys'fees, costs of litigation, and related
expenses, both at the trial and appellate levels.
7. GOVERNING LAW; ATTORNEY'S FEES AND COSTS; VENUE: This Agreement
is made in the State of Florida and will be governed by Florida law. This Agreement may be signed
in more than one counterpart, in which case each counterpart will constitute an original of this
Agreement. Paragraph headings are for convenience only and are not intended to expand or restrict
the scope or substance of the provisions of this Agreement. Wherever used herein, the singular
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will include the plural,the plural will include the singular,and pronouns will be read as masculine,
feminine, or neuter as the context requires. Monroe County, Florida will be the proper venue for
any litigation involving this Agreement. This Agreement is not subject to arbitration.
8. OTHER TERMS AND CONDITIONS:
A. Except as set forth herein,the Employee is subject to all terms and conditions set
forth in the Monroe County Personnel Policies& Procedures Manual ("Manual")
and Monroe County Fire Rescue Standard Operating Procedures as may be
amended from time to time. To the extent there is a conflict between the terms of
this Agreement and the Manual,the terms of this Agreement shall prevail.
B. If any provision, term, or portion of this Agreement shall be held to be
unconstitutional, illegal, invalid, or enforceable by a court of competent
jurisdiction, the remaining terms, conditions, and portions shall remain in full
force and effect as if originally agreed to without the term, condition, or portion
that has been determined to be unconstitutional, illegal, invalid or unenforceable.
C. The waiver by either the County or the Employee of a breach or violation of any
term or provision of this Agreement by the other party shall not operate or be
construed as a waiver of any subsequent breach or violation by the other party.
D. The County and Employee acknowledge that each has shared equally in the review
of this Agreement and, accordingly, no court or administrative hearing officer
shall construe any provision of this Agreement more strictly against one party over
the other party, and every term, condition, covenant, and provision of this
Agreement shall be construed simply according to its fair meaning. Employee
further acknowledges that she or he has had the Agreement reviewed by an
attorney or has been given the opportunity to do so and has waived that
opportunity.
E. This Agreement incorporates and supersedes all prior negotiations,
correspondence, conversations, agreements, and/or understandings applicable to
the matters contained herein. It is further agreed that there are no commitments,..
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agreements, inducements, or understandings concerning the subject matter of this
Agreement that are not contained herein, and no deviation from the terms hereof
shall be predicated upon any prior representations, offers, promises, inducements,
or agreements, whether oral or written, and by whomever made.
F. The text herein constitutes the entire agreement between the Employee and the
County, and this agreement cannot be amended except by a written document
mutually agreed to and executed with the same formalities as this Agreement. The
rights and obligations of this Agreement are personal to the Employee and cannot
be assigned or transferred.
9. CONTRACTS; PUBLIC RECORDS-F.S.119.0701:
A. For purposes of this section, the term:
i. "Contractor"means an individual, partnership, corporation, or
business entity that enters into a contract for services with a public
agency and is acting on behalf of the public agency as provided under
s. 119.011(2).
ii. "Public Agency"means a state,county, district, authority, or municipal
officer,or department, division, board, bureau, commission, or other
separate unit of government created or established by law.
B. In addition to other contract requirements provided by law, each public agency
contract for services must include a provision that requires the contractor to comply
with public records laws, specifically:
Public Records Compliance. Contractor must comply with Florida public records
laws, including but not limited to Chapter 119, Florida Statutes and Section 24 of
article I of the Constitution of Florida. The County and Contractor shall allow and
permit reasonable access to, and inspection of, all documents, records, papers,
letters or other"public record" materials in its possession or under its control
subject to the provisions of Chapter 119, Florida Statutes, and made or received by
the County and Contractor in conjunction with this contract and related to contract
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performance. The County shall have the right to unilaterally cancel this contract
upon violation of this provision by the Contractor. Failure of the Contractor to abide
by the terms of this provision shall be deemed a material breach of this contract and
the County may enforce the terms of this provision in the form of a court proceeding
and shall, as a prevailing party, be entitled to reimbursement of all attorney's fees
and costs associated with that proceeding. This provision shall survive any
termination or expiration of the contract. The Contractor is encouraged to consult
with its advisors about Florida Public Records Law in order to comply with this
provision.
Pursuant to F.S. 119.0701 and the terms and conditions of this contract, the
Contractor is required to:
i. Keep and maintain public records that would be required by the
County to perform the service.
ii. Upon receipt from the County's custodian of records, provide the
County with a copy of the requested records or allow the records to
be inspected or copied within a reasonable time at a cost that does
not exceed the cost provided in this chapter or as otherwise
provided by law.
iii. Ensure that public records that are exempt or confidential and
exempt from public records disclosure requirements are not
disclosed except as authorized by law for the duration of the contract
term and following completion of the contract if the contractor does
not transfer the records to the County.
iv. Upon completion of the contract, transfer, at no cost,to the County
all public records in possession of the Contractor or keep and
maintain public records that would be required by the County to
perform the service. if the Contractor transfers all public records to
the County upon completion of the contract, the Contractor shall
destroy any duplicate public records that are exempt or confidential
and exempt from public records disclosure requirements. If the
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Contractor keeps and maintains public records upon completion of
the contract, the Contractor shall meet all applicable requirements
for retaining public records. All records stored electronically must
be provided to the County,upon request from the County's custodian
of records, in a format that is compatible with the information
technology systems of the County.
V. A request to inspect or copy public records relating to a County
contract must be made directly to the County,but if the County does
not possess the requested records, the County shall immediately
notify the Contractor of the request,and the Contractor must provide
the records to the County or allow the records to be inspected or
copied within a reasonable time.
If the Contractor does not comply with the County's request for
records, the County shall enforce the public records contract
provisions in accordance with the contract, notwithstanding the
County's option and right to unilaterally cancel this contract upon
violation of this provision by the Contractor. A Contractor who fails
to provide the public records to the County or pursuant to a valid
public records request within a reasonable time may be subject to
penalties under Section 119.10, Florida Statutes.
Contractor shall not transfer custody, release, alter, destroy or
otherwise dispose of any public records unless or otherwise
provided in this provision or as otherwise provided by law.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF
CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE
CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY, AT (305)292-3470.
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HAI L.E i( IR Atl;, ^l��l ��,'�)��iI�JMJI ,.'!��1�.�" �"� �rlf �„�i� MONROE COUNTY
ATTORNEY'S OFFICE, 1111 12th STREET, SUITE 408, KEY WEST, FL 33040.
IN WITNESS WHEREOF, the parties have set their hands and seals, in the County of
Monroe, Florida this day of July, 2024.
MONROE COUNTY FIRE RESCUE
By:
James K. Callahan, Fire Chief
WITNESS; EMPLOYEE
By: 01 •
Sicon "Leah"Fennesse
ATTEST: MONROE COUNTY BOARD OF
KEVIN MADOK,MONROE COUNTY COUNTY COMMISSIONERS
CLERK
BY: By: .........
___.___.
As Deputy Clerk Mayor
BOARD OF GOVERNORS OF FIRE
#VROE r Arms EY; AND AMBULANCE DISTRICT 1 OF
FORM MONROE COUNTY,FLORIDA
AS81 � ,MY ATTORNEY
B
Datefi/21124 Y: ..........................................................._.,,,..,,.,,.,. .,,,,,,,,,.�
Mayor/Chairperson
Billing Specialist Employment Contract
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MONROE COUNTY
... .......
, 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, HCPCS, 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.
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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:01/16/2024
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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 coworkers 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 human 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 handling.
• 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:01/16/2024
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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.
go
Employee SI nature Date
Digitally signed by James K.
James K. Callahan'Callahan
Da1e;2024.01.10 11,34 14 M?00'
Supervisor or Director Signature Date
)1240;tl2 Bryan Cook .1 "2021 1 5' '
Director of Employee Services Signature Date
E.O.E. 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
Kevin Madok, CPA
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you . Clerk of the Circuit Court& Comptroller Monroe bounty, Florida
DATE: August 31, 2021
TO: Chief Steve Hudson
Fire Rescue/EMS
Cheri Tamborski
Executive Administrator
FROM: Pamela G. Hancock, D.C.
SUBJECT: August 18t' BOCC Meeting
Attached is an electronic copy of the following item for your handling:
C12/H1 Employment Agreement with Dixie "Sandy" Roussin to fill a vacant Fire
Rescue EMS Billing Specialist position.
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 PK/ROTH BUILDING
500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road
Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florid,-gg07O
305-294-4641 305-289-6027 305-852-7145 305-852-7145 937
EM[PLOYMENT AGREEMENT BETWEEN
THE OE COUNTY BOARDOF COUNTY CO SSIO ;
BOARDTHE OF GOVERNORS OF MONROE COUNTY
FIRE&AMBULANCE DISTRICT Ij AND
D "S Y"ROUSSIN
FOR THE POSITION OF EMS BILLING SPECIALIST
THIS AGREEMENT is entered into upon the date last below written by and between
'Monroe County,Florida, ' g 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 Dixie"Sandy"Roussin("Employee"}.
WHEREAS,the position of EMS Billing Specialist is currently open;and
the BOCC has solicited applicants for the position; and
Employee has interviewed and been selected for the positron,and
the County has conducted an internal and external applicant search to fill the
open position and has selected Dixie"Sandy"Roussin to fill the position;and
WEEREAS9 the parties desire to enter into a contract to became eff-ective on July 12,
2021.
NOW THEREFORE, in comidpration of the mutual promises contained herein, the
County and Employee set forth herein,it is mutually agreed as follows:
1. EMPLOYMENT: Employee is hereby employed as the EMS Billing Specialist as a
Contract Employee as that term is defined in Section 2.03 of the Personnel Policies&Procedures
Manual
CiManual").
2. D : Duties of the Employee will be as set forth in the Job Description attached
hereto as Exhibit A,the provisions of which are incorporated herein by reference.
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A. The Employee shall not disclose to any person, party, or entity any confidential,
proprietary, time-sensitive, or non-public (including HIPAA) information relating to the
County or its operations unless required by law to do so.
B. Upon termination of this Agreement,the Employee agrees to immediately surrender
all documents,information,property and assets to Monroe County Fire Rescue("MCFWI.
C. Due to the requirements of this position, Employee is required to be physically
present at the EMS Billing Office located at 490 63'' Street, Marathon, FL 33050 for a
minimum of 40 hours per week.
3. COMPENSATION AND BENEFITS: County and Employee agree that the position
of EMS Billing Specialist will be a frill-time position deemed non-exempt under the Fair Labor
Standards Act. Work hours performed,annual leave,personal Ieave,and sick leave hours taken
will be documented on a form or forms to be provided by the County,or by another method as
designated by the County.
A. Base Pay: 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$48,000.
B. Financial Incentive: In lieu of any annual merit or cost-of-living adjustment, the
Employee will be eligible for a financial lump sum incentive based upon billing and
collections performance. After the conclusion of each billing and collections performance
review period,'a comparison of EMS user fee revenue will be conducted to determine
whether a supplemental lump-sum payment is warranted for increased revenue receipts,
not to exceed ten percent(10%a)of base salary.
C. Benefits: Except as otherwise set forth herein,the Employee shall also receive all
benefits set forth in the Monroe County Personnel Policies&Procedures Manual
("Manual")as said Manual may be amended from time to time.
D.Transportation and Business Related Travel: Employee agrees that she will be
responsible for providing her own motor vehicle for transportation. MCFR agrees to
budget and pay for the costs incurred by the Employee in attending approved seminar and
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939
continuing education courses as may be deemed necessary or appropriate to employee's
duties and responsibilities under this Agreement and in accordance with County policy.
i.Employee agrees to obtain EMS Ambulance Billing and Coding Certification,
within 12 months of the execution of this agreement. Tuition costs related to
the certification are eligible for reimbursement by MCFR of the actual
expenditure in accordance with Section 2.11 ofthe Monroe County Personnel
Policies and Procedures 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. SOLE EMPLOYMENT: The Employee agrees that he or she will not perform any
work, consulting services, or other activities for any other person or entity, whether for
remuneration or at no charge,without the prior express written approval of MCFR..
5. TERM OF AGREEMENT;TERMINATION; CANCELLATION; GENERAL
RELEASE:
A. Normal Term. The normal term of this Agreement will be a period of twenty-four
(24)months commencing July 12,2021 and terminating on July 11,2023.
B. Extension of Time. The parties may extend the term of Agreement by written
addendum to this Agreement.
C. Termination of Agreement:
i.In entering into this Agreement,the Employee understands that she serves at
the pleasure of MCFR, and that the Employee can be terminated at any time
upon thirty(30)days written notice by MCFR without cause.
I In entering into this Agreement, the Employee also understands that she can
be terminated at any time upon 24 hours written notice by MCFR for cause.
As used in this paragraph,the term "for cause" will mean(a) dishonesty with
respect to the business and operation of the County;(b)confirmed violation of
the County's drug policy; (c)refusal to cooperate in an investigation regarding
any aspect of the business or operation of the County,including but not limited
Billing Specialist Employment.Contract
(Dixie"Sandy"Roussin) Page 3 of
940
to an investigation which is conducted by or at the express.direction of the
BOCC; (d) conviction of a crime which is classified as a felony or a crime
involving moral turpitude; (e) gross neglect or willful and intentional
misconduct; (f) conviction of a crime; (g) violation of a provision of the
Monroe County Code; or(h) breach of any material term or condition of this
Agreement by the Employee.
iii. The Employee further understands that in the event of termination, the
Employee is free to apply to the County for any other position then currently
open and the County is free to consider the Employee for any open position,
but that County has no obligation to place the Employee in another position,
and.specifically has no obligation to place the Employee in a position of
equivalent or comparable salary, grade, or benefits. In entering into this
Agreement,the Employee therefore specifically waives the right to utilize the
grievance procedure set forth in Sections 9 and 10 of the Manual;House Bill.
No. 2658, Chapter 69-1321, the Monroe County Career Service Council; as
well'as any rights to which a Monroe County employee would otherwise be
entitled under Chapter 447,Florida Statutes.
iv. Resignation. In the event the Employee resigns from the position prior to the
normal expiration date of this Agreement,the Employee shall be entitled only
to payment for salary through the effective date of the resignation and any
accrued annual and sick leave in accordance the Monroe County Personnel
Policies and Procedures.
6. ATTORNEY'S FEES AND COSTS: In the event of any litigation initiated by either
party,the prevailing party shall receive reasonable attorneys'fees,costs of litigation,and related
expenses,both at the trial and appellate levels.
7. GOVERNING LAW,ATTORNEY'S FEES AND COSTS;VENUE: This Agreemef
is made in the State ofFlorida and will be governed by Florida law.This Agreement may be signed
in more than one counterpart, in.which case each counterpart will constitute an original of this
Agreement.Paragraph headings are for convenience only and am not intended to expand or restrict
Billing Spetiallst Employment Contract
JDb(1e"Sandy"Roussin) Page 4 of 9
941
the scope or substance of the provisions of this Agreement, Wherever used herein, the singular
will-include the plural,the plural will include the singular,and pronouns will be read as masculine,
f ' 'ne, or neuter as the context requires. Moproe County, Florida will be the proper venue for
any Iitigation involving this Agreement.This Agreement is not subject to arbitration.
8. OTHER TERMS AND CONDITIONS:
A. Except as set forth herein,the Employee is subject to all terms and conditions set
forth in the Monroe County Personnel Policies&Procedures Manual("Manual")
and Monroe County Fire Rescue Standard Operating Procedures as may be
ended from time to time.To the extent there is a conflict between the'terms of
this Agreement and the Manual,the terms of this Agreement shall prevail.
B. If any provision, term, or portion of this Agreement shall be field to be
unconstitutional, illegal, invalid, or enfarceable by a court of competent
jurisdiction, the ` ` terms, conditions, and portions shall remain in full
force and effect as if originally agreed to without the term, condition, or portion
that has been determined to be unconstitutional; illegal,invalid or unenforceable.
C. The waiver by either the County or the Employee of a breach or violation of any
term or provision of this Agreement by the other party shall not operate or be
construed as a waiver of any subsequent breach or violation by the other party.
D. The County and Employee acknowledge that each has shared equally in the review
of this Agreement and, accordingly, no court or administrative hearing officer
shall construe any provision of this Agreement more strictly against one party over
the other party, and every term, condition; covenant, and provision of this
Agreement shall be construed simply according to its fair meaning. Employee
further aclmowledes that she or he has had the Agreement reviewed by an
attorney or has been given the opportunity to do so and has waived that
opportunity.
Billing Specialist Employment Contract
(pixie"Sandy"Roussin) Page 5 of 9
942
E. This Agreement incorporates and supersedes all, prior negotiations,
correspondence, conversations, agreements, and/or understandings applicable to
the matters contained herein. It is further agreed that there are no commitments,
agreements,inducements,or understandings concerning the subject matter of this
Agreement that are not contained herein,and no deviation from the terms hereof
shall be predicated upon any prior representations,offers,promises,inducements,
or agreements,whether oral or written,and by whomever made.
F. The text herein constitutes the entire agreement between the Employee and the
County, and this agreement cannot be amended except by a written document
mutually agreed to and executed with the same formalities as this Agreement.The
rights and obligations of this Agreement are personal to the Employee.and cannot
be assigned or ftwisferred.
9. CONTRACTS;PUBLIC RECORDS-F.S.119.0701:
A. For purposes of this.section,the term:
i."Contractor"means an individual,partnership,corporation,or business
entity that enters into a contract for services with a public agency and is
acting on behalf of the public agency as provided under s. 119.011(2).
ii."Public Agency"means a state,county, district,authority,or municipal
officer,or department, division,board,bureau,commission,or other
separate unit of government created or established by law.
B. In addition to other contract requirements provided by law,each public agency
contract for services must include a provision that requires the contractor to comply
with public records laws, specifidally:
Public Records Compliance. Contractor must comply with Florida public records
laws, including but not limited to Chapter 119,Florida Statutes and Section 24 of
article I of the Constitution of Florida.The County and Contractors allow and
permit reasonable access to, and inspection of, all documents, records, papers,
letters or other"Public record" materials in its possession or under its control
Billing Specialist Employment Contract
(Dixie"Sandy" Roussln) Page 6 of 9
943
subject to the provisions of Chapter 119,Florida Statutes,and made or received by
the County and Contractor in conjunction with-this contract and related to contract
performance. The County shall have the right to unilaterally cancel this contract
upon violation of this provision by the Contractor.Failure of the Contractor to abide
by the to of this provision shall be deemed a material breach of this contract and
the County may enforce the terms ofthis provision in the form of a court proceeding
and shall, as a prevailing party, be entitled to reimbursement of all attorney's fees
and costs associated with that proceeding, This provision shall survive any
termination or expiration of the contract. The.Contractor is encouraged to consult
with its advisors about Florida Public Records Law in order to comply with this
provision.
'Pursuant to F.S. 119.0701,and the terms and conditions of this contract, the
Contractor is required to:
i. Keep and maintain public records that would be required by the
County to perform the service.
I Upon receipt-from the County's custodian of records,provide the
County with a copy of the requested records or allow the records to
be inspected or copied within a reasonable time at a cost that does
not exceed the cost provided in this chapter or as otherwise
provided by law.
iii. Ensure that public records that are exempt or confidential and
exempt from public records disclosure requirements are not
disclosed except as authorized by law for the duration of the contract
term and following completion of the contract ifthe contractor does
not transfer the records to the County.
iv. Upon completion of the contract,transfer,at no cost,to the County
all public records in possession of the Contractor or keep and
maintain public records that would be required by the County to
perform the service. If the Contractor transfers all public records to
the County upon completion of the contract, the Contractor shall
Billing Specialist Employment Contract
(Dixie"Sandy" Roussin) Page 7 of 9
944
destroy any duplicate public records that are exempt or confidential
and exempt from public records disclosure requirements. If the
Contractor keeps and maintains public records upon completion of
the contract, the Contractor shall meet all applicable requirements
for retaining public records. All records stored electronically must
be provided to the County,upon request from the County's custodian
of records, in a format that is compatible with the information
technology systems of the County.
V. A request to inspect or copy public records relating to a County
contract must be made directly to the County,but if the County does
not possess the requested records, the County shall immediately
notify the Contractor of the request,and the Contractor mustprovide
the records to the County or allow the records to be inspected or
copied within a reasonable time.
If the Contractor flocs not comply with the County's request for
records, the County shall enforce the public records contract
provisions in accordance with the contract, notwithstanding the
County's option and right to unilaterally cancel this contract upon
violation of this provision by the Contractor.A Contractor who fails
to provide the public records to the County or pursuant to a valid
public records request within a reasonable time may be subject to
penalties under Section 119.10,Florida Statutes.
Contractor shall not transfer custody, release, alter, destroy or
otherwise dispose of any public records unless or otherwise
provided in this provision or as otherwise provided by law.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119,FLORIDA STATUTES,TO
Blillng Specialist Employment Contract
(Dixie"Sandy'Roussin) Page 8 of S
945
THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC
RECORDS RELATING TO THIS CONTRACT, CONTACT THE
CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY, AT
(305)292-3470. BRADLEY-BR1ANtaMONROECOUNTY-
FL.00V, MONROE COUNTY ATTORNEY'S OFFICE, I I I I
12th STREET, SUITE 408, KEY WEST, FL 33040.
IN WITNESS WHEREOF,the parties have set their hands and seals, in the County of
Monroe, Florida this a]tz day of6j4&C t.44,, 2021.
r°i►* '`'' VALERI A KOLESSAR MONROE OUNTY FIR SCUE
Notary Public-State of Florida
�T Commission M HN 145959
� Iv My Comm.Expires Aug 15,2025
Bonded through National Notary Assn.
By: C
Steven C. Hudson,Fire Chief
WITNESS: EMPLOYEE
G G� By:X'S "....�'
� .
1 .� Dixie Sandy"Roussin
�d <ATt',Ft MONROE COUNTY BOARD OF GQUNTY a w
rICE N (Ab0 MONROE COUNTY COMMISSIONERS — r
Pad,%��wJ• � \-i a �- _' rv,_
B By: VV/��/���J�J r r s
As Deputy Clerk Mayor 7-1 CD
MONROE COUNTY ATTORNEY BOARD OF GOVERNORS OF FIRE AND
Approved as to form and content: AMBULANCE DISTRICT 1 OF MONROE
COUNTY, FLORIDA
By: By:
Assistant County Attorney Mayor/Chairperson
it NROE COUNTY ATTOFINEY
A 'pOVE t FORM
Billing Specialist Employment Contract
O
(Dixie"Sandy"Roussin) ASSI PED J.UNTY ATTORNEY Page 9 of 9
Date 8/30/21
946
MONROE COUNTY'
F 31DA
LOr
Job Description
To perfonn ms job successifulty afY nljjj 1 r)e abfp fo '#dofrn the ossqnrjd1 "130 fur7etions sabsfactc,"Wily
Reasonable arcommodations Maybe Onazle to enable Sndiv,,duafs iwth disabilibes to piripfcorrY,Me Pornary,lob fun Ctpons
herwri described Since every duty asscioated with this Vasit-in ,nay nor be describeo hereerr erriployees rriay be
requirecir to pelfbm duties not specifically spelled out art the loft descvpfion but which rr4y be reasonably conslaered
to be incidental in the performing of thotf(Juties just as though they were actualfy wrIten out in this job clescniobon
Job Title-. Billing Specialist, Fire Rescue EMS
Department: Monroe County Fire Rear le
Pay Grade; Contract
FLSA Status: Non-exempt
�MA�RY
The primary function of this position rs, under the direction of the, Fire Rescue EMS Billing
Supervisor, to be responsible for report review, data entry and retrieval,, and records
maintenance of an air and ground EMS billing program; and for performing complex
administrative work within the division of Emergency Services,
ESS�NT
• Reviews ePCR reports to ensure complete and accurate patient dernographic, trip, billing,
and insurance Wormation: refers incomplete or inaccurate, records to EMS Quality
Assurance.
• Verifies or assigns condition codes,modifiers,levels of service,and other relevant claim data.
• Scans and attaches biomedical and supporting trip records to eiectronk:patient care reports.
• 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,
• Assists Billing Supervisor with collection actions, including contacting patients by phone and
arranging payments,
• Runs account aging and other related blihng reports,
• Processes and posts Medicare,Medicaid,check,and credit card payments regularly, Reviews
and processes refunds as needed.
• Processes Air Resident (Trauma Star) waivers.
• Processes legal records requests for patient care reports and response records.
QJ, Performs monthly EMSTARS extract and data submission to Department of Health, State
EMS Division to comply with mandatory pre hospital reporting requirements,
Monroe County rL Billing Sp,��[Ah"t, F,rk,Rp, Cue EMS Updaied 41,1612021
947
BUbg spas R t,Fire Rescue Elms Page Z
■ Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations and
County/Department policies and Procedures.
• Completes and maintains purchase orders, processes Invoices, orders supplies, keeps
Inventory records,processes mail.
m Processes Ri Fs, contracts, renewals, purchases, agenda items, special projects, and
maintains records.
• Assists Ili budget preparation and monitoring expenses.
• Performs other related Job duties as assigned.
• May be required to provide disaster assistance during times of emergency in any capacity
deemed appropriate.
QUALEFi Ti �5
Education and perie ce:
Highschool Diploma or GE:D required. S years minimum of prior related work experience
preferred
Special Qualifications:
Certified Ambulance Coder within one year of employment.
Knowledge,Skills and Abilities:
• Ability to make recommendations or decisions which usually affect the assigned
department, but: may-at times affect operations, services, Individuals, or activities of
others outside of the assigned department,
• Ability to use and apply technical and detailed guidelines.
• Moderate analytic ability Is deeded to gather and Interpret data where results/answers
can be found after analysis of several'fa .
• Ability to usei independent judgment to study previously established, often partlaily,
relevant guidelines;plan forvarlous Interrelated activities;and coordinate such activities
within a work unit or while completing a projecL
• Ability to maintain regular Internal and external coritacts to carry out programs and to
explain specialized matters.
e Abliltyto maintain contact with officials at higher levels on matters requiring cooperation,
explanation, and persuasion, as well as with the public Involving the enforcement of
regulations,policies,and procedures.
`the work Is sedentary and requires exerting up to 1.0 pounds of force occasionally and/or
negligible amount of Force frequently or constantly to lift, carry,push, pull or otherwise move
oblects,Including the human body.Additionally,the following-physicalabilities are required:
• "Manual Dexterity: Picking,pinching,typing,or otherwise working,primarily with fingers
rather then with the whole hand as in handling,
• Mental Aculty: Ability to make rational decisions through sound logic and deductive
processes.
Monroe County.FL MRIng Spedalls+.Rre Reseua EMS Updated:4/16/20n
948
Billing 'mist,Fire Rescoe EMS —---------- Page 3
# 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 includlng 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 terrninah; and/or extensive
reading,
G Walking: Moving about on foot to accomplish tasks, particularly for long distances or
moving from one work site to another.
WDRK QPY_Yt_QAMLNT
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 Croun ty has the right to revise this jo:b description at on y time. This
description does not represent in any way a contract of employment.
,)
Employed Sign sere Date
Spervisor or Director Signature Date
DBIk"lly�igrwd bv 9 ya,,Cwk
Bryan Cook Date:2021 a7 29 1020',J4
Director of Employee Service Signature Date
LQ& Monroe County does not discriminate on the basis of race, cofor, norionai origin, gender, religion, age,
disability or military service in employment or the provision of services.
Monroe Cc unty,FL Billing spec�atlst.rfre Rescue EMS Updated:4/1612,021
949
GVR GOUqrQ
Kevin Madok, cPA
Clerk of the Circuit Court&Comptroller
oe�o; Monroe County, Florida
DATE: June 22, 2023
TO: Cheri Tamborski
Emergency Services
FROM: Pamela G. Haiic .
SUB,JECr- June 21°BOCC Meeting
Attached is an electronic copy of the following item for your handling:
C21/1-1 1 1st Addendum to Employment Agreement with Dixie "Sandy"Roussin for Fire
Rescue EMS Billing Specialist position witi an increase in salary from$48,000 to $52,000 to
commence on July 12, 2023 and terminate on July 11, 2025.
Sliould 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
950
FIRST ADDENDUM TO EMPLOYMENT AGREEMENT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS,
THE BOARD OF GOVERNORS OF MONROE COUNTY
FIRE & AMBULANCE DISTRICT 1,AND
DIXIE "SANDY"
ROUSSIN
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 (" "), a political subdivision of the State of Florida,
whose main business address is 1100 Simonton tret, Key West, Florida 3 ; the Board
Governors of
®Monroe County ire Ambulance District 1 (collectively "County") an Dixie
"Sandy" oussin ("Employee").
e County entered into an Employment Agreement ("Agreement") with
Dixie "Sandy" o ssin on July 12, 2021 fora period of twenty-four ( ) months forte position
of EMS BillingSpecialist which is due to expire on July 1 , 2 2 ; and
the Employment Agreement allows the parties to extend the employment
term by written addendum; and
the Employee has satisfactorily performed her duties therefore the parties
desire to update several terms and extend the term of the contract fora period of two years,
becoming effective on July 12, 2023 and terminating July 11, 2025, subject to modification o
certain other terms within the Agreement; an
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 BillingSupervisor, Employee may be required to be physically present at the
Billing Specialist Employment Contract
(Dixie"Sandy" Ro ssi ) Page I of 3
951
EMS Billing Office located at 490 63d Street, Marathon, FL 33050 fora 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-two thousand dollars ($52,000).
3. Paragraph 3O(i) is amended to read as follows: Employee agrees toobtain EMS
Ambulance Billing and Coding Certification while employed by Monroe County as an
EMS Billing Specialist and during the term oft is Agreement. Tuition costs related to
the certification are eligible for reimbursement by Monroe County Fire Rescue ofthe
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 oft e 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 ofthis Agreement as
extended by this Addendum will be fora period of twenty-four (24) months
commencing July 12, 2023 and terminating on July 11, 2025.
(signatures on next page)
Billing Specialist Employment Contract
(Dixie"Sandy" Roussin) Page 2 of 3
952
IN WITNESS WHEREOF,the parties have set their hands and seals, in the County of
Monroe,Florida this 21st day of June , 2023.
MARY J MOELLER MONROE COUNTY FIRE RESCUE
Notary Public•State of Florida
Commission 0 GG 977619
My Comm.Expires Apr 12,2024
"Bonded through National Notary By:
Assn. /�
..
rnes Callahan,Fire Chief
WITNESS: EMPLOYEE
By: o ^`°
Dixie"Sandy" Roussin
s 23 BOARD OF COUNTY
VIN MADOK, CLERK COMMISSIONERS
Q91, O?
*OD*COON
As Deputy`Clerk By:
Mayor Pro Tern
MONROE COUNTY ATTORNEY BOARD OF GOVERNORS OF FIRE
Approved as to form and content: AND AMBULANCE DISTRICT 1 OF
MONK COUNTY, I A
By: By: ;
Assistant County Ate orney Mayor/Chairperson
Date:513123
c7 L M
:-T1 r—
��
`x
p
D :
Billing Specialist Employment Contract •.. o
(Dixie"Sandy",Roussin) Page 3 of 3
953
dq
u0
SECOND ADDENDUM TO EMPLOYMENT AGREEMENT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS,
THE BOARD OF GOVERNORS OF MONROE COUNTY
FIRE &AMBULANCE DISTRICT 1,AND
DVUE"SANDY"ROUSSIN
FOR THE POSITION OF EMS BILLING SPECIALIST
THIS SECOND 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 Dixie
"Sandy"Roussin("Employee").
WHEREAS,the County entered into an Employment Agreement("Original Agreement")
with Dixie "Sandy" Roussin on July 12, 2021 for a period of twenty-four (24) months for the
position of EMS Billing Specialist which is due to expire on July 11, 2023; and
WHEREAS, the Employment Agreement allows the parties to extend the employment
term by written addendum; and
WHEREAS,on June 21, 2023 the BOCC approved the First Addendum ("I't Addenum")
to Employment Agreement which,among other things,extended the employment term for a period
of 24 months commencing July 12, 2023 and terminating on July 11,2025,and
WHEREAS, due to the hiring of a new EMS Billing Specialist, the County would like to
increase Employee's salary to provide equity across the EMS Billing Specialists based upon
experience and performance; and
WHEREAS,the County desires to extend the term of Ms. Roussin's agreement in order
to make the EMS Billing Specialist Agreement co-terminus.
NOW THEREFORE, in consideration of the mutual promises contained herein, the
County and Employee set forth herein, it is mutually agreed as follows:
Section 1• Paragraph 3(a) of the Original 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's annual salary will
increase from fifty-two thousand dollars ($52,000)to fifty-seven thousand dollars
($57,000).
Billing Specialist Employment Contract
(Dixie"Sandy" Roussin) Page 1 of 2
L0
L0
Section 2. Paragraph 5(a) of the Original Agreement 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 June 24, 2024 and terminating on
June 23„2026.
Section 3. Except as set forth in Sections 1 and 2 of this 2"d Addendum, the terms and
conditions of the Original Agreement dated July 12, 2021 and the I' Addendum
approved June 21, 2023,not inconsistent herewith,remain in full force and effect.
IN WITNESS WHEREOF, the parties have set their hands and seals, in the County of
Monroe, Florida this day of.............................................................................. 2024.
MONROE COUNTY FIRE RESCUE
By: ..
James Callahan, Fire Chief
WITNESS: EMPLOYEE
By: By. :::::::::::. :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
Dixie"Sandy"Roussin
(SEAL) BOARD OF COUNTY
ATTEST: KEVIN MADOK,CLERK COMMISSIONERS
As Deputy Clerk Mayor
""!ONROE CO ATTDFlN�Y(11.1BOARD OF GOVERNORS OF FIRE
Hou FORM AND AMBULANCE DISTRICT 1 OF
MONROE COUNTY,FLORIDA
R'
ASS4 MY ATEUIINEIf
pat@ 6/26/24
By: ......
Mayor/Chairperson
Billing Specialist Employment Contract
(Dixie"Sandy" Roussin) Page 2 of 2
W
LO
INA 11011: 1 4 1mlil I�Ei COUNTY
FLOCIUDA
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, HCPCS, 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
d ata.
• Scans and attaches biomedical and supporting trip records to electronic patient care
reports.
I-
L0
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:01/26/2024
00
LO
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 human 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 handling.
• 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:01/16/2024
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
Employee Signature Date
Digitally signed by James K.
James K. Callahan Callahan
te:2024.01.1911:34:14-05'
Supervisor or Director Signature Date
Digitally signBryan Cook
Bryan CookDate,M24.011..22y12W12-05W
Director of Employee Services Signature Date
E D.E. 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
Liz Yongue
From: Gomez-Krystal <Gomez-Krystal@MonroeCounty-FL.Gov>
Sent: Friday, July 12, 2024 1:35 PM
To: Ballard-Lindsey; County Commissioners and Aides; Kevin Madok; Pamela G. Hancock;
Senior Management Team and Aides; Liz Yongue; InternalAudit
Cc: Gastesi-Roman; Shillinger-Bob; Williams-Jethon; Cioffari-Cheryl; Livengood-Kristen;
Rubio-Suzanne; Pam Radloff; County-Attorney; Allen-John; Danise Henriquez; Hurley-
Christine; Rosch-Mark; Gambuzza-Dina; Beyers-John; InternalAudit; Kevin Madok;
Valcheva-Svilena
Subject: Item C21 BOCC 07/17/2024 REVISED ITEM WORDING & BACK-UP.
Attachments: AIS 2623 C21.pdf, Addendum to Employment Agreement for Sandy Roussin Expires
06.23.2026 v2.pdf
Good Afternoon,
Please be advised, the agenda item wording and back-up have been revised for item C21.
"Ratification by the BOCC ofan Employment Agreement with Leah Fennessey hired to fill a vacancy as a
Monroe County Fire Rescue (MCFR)EMS Billing Specialist with an annual salary of$55,000, commencing on
June 24, 2024 and expiring on June 23, 2026; and authorizing the County Administrator/Fire Chief to execute
all necessary documents. Ratification by the BOCC is also being requested for execution of an Addendum to
Employment Agreement with Sandy Roussin for an equity adjustment in annual salary from $52,000 to $57,000,
commencing on June 2 July 14, 2024 and expiring on June 23, 2026; and authorizing the County
Administrator/Fire Chief to execute all necessary documents. "
Sincerely,
Executive Administrator
Monroe County Administrator's Office
1100 Simonton Street, Suite 2-205
Key West, FL 33040
(305)292-4441 (Office)
(305)850-8694(Cell)
Courier Stop#1
Notary Public
w.r o n r y e c_ u�n1y:�:V_e.gpy
i».c z..- Y .�.. _rn nroecou�_n�.Y..-.�..:.i» .Y.
PLEASE NOTE: FLORIDA HAS A VERY BROAD RECORDS LAW. MOST WRITTEN COMMUNICATIONS TO OR FROM THE COUNTY REGARDING COUNTY BUSINESS
ARE PUBLIC RECORDS AVAILABLE TO THE PUBLIC AND MEDIA UPON REQUEST. YOUR EMAIL COMMUNICATION MAY BE SUBJECT TO PUBLIC DISCLOSURE.
1
C21
BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE i Mayor Holly Merrill Raschein,District 5
The Florida Keys Mayor Pro Tern James K.Scholl,District 3
Craig Cates,District 1
Michelle Lincoln,District 2
' David Rice,District 4
Board of County Commissioners Meeting
July 17, 2024
Agenda Item Number: C21
2023-2623
BULK ITEM: Yes DEPARTMENT: Fire Rescue
TIME APPROXIMATE: STAFF CONTACT: James K. Callahan
N/A
AGENDA ITEM WORDING:
Ratification by the BOCC of an Employment Agreement with Leah Fennessey hired to fill a vacancy as
a Monroe County Fire Rescue (MCFR) EMS Billing Specialist with an annual salary of $55,000,
commencing on June 24, 2024 and expiring on June 23, 2026; and authorizing the County
Administrator/Fire Chief to execute all necessary documents. Ratification by the BOCC is also being
requested for execution of an Addendum to Employment Agreement with Sandy Roussin for an equity
adjustment in annual salary from $52,000 to $57,000, commencing on Rtne 24 July 14, 2024 and
expiring on June 23, 2026; and authorizing the County Administrator/Fire Chief to execute all
necessary documents.
ITEM BACKGROUND:
The MCFR EMS Billing Specialist position needs to be filled due to a vacancy by one of the EMS
Billing Specialists and MCFR desires to provide the existing EMS Billing Specialist with an equity
adjustment in annual salary as she has held that position for over three (3) years and has substantial
medical billing experience.
PREVIOUS RELEVANT BOCC ACTION:
06/21/23: BOCC and BOG approved a First Addendum to Employment Agreement with Dixie "Sandy"
Roussin for EMS Billing Specialist position.
08/18/21: BOCC and BOG approved an Employment Agreement with Dixie "Sandy" Roussin to fill a
vacant Fire Rescue EMS Billing Specialist position.
06/21/17: BOCC and BOG approved the Employment Agreement for one additional Billing Specialist.
02/15/17: BOCC and BOG approved creating a second EMS Billing Specialist position as a Monroe
County contract employee.
1
INSURANCE REQUIRED:
No
CONTRACT/AGREEMENT CHANGES:
Employment Agreement for Leah Fennessey to commence on June 24, 2024 and expire on June 23,
2026 and Second Addendum to Employment Agreement for Sandy Roussin to commence on Rtfle 24 ,
July 14, 2024 and expire on June 23, 2026.
STAFF RECOMMENDATION: Approve
DOCUMENTATION:
Employment Agreement for Leah Fennessey- Expires 06.23.2026 Signed Version.pdf
Roussin, Dixie Sandy- Expires 7-11-2023.pdf
Roussin, Dixie Sandy- C21 and H I Expires 7-11-2025.pdf
Addendum to Employment Agreement for Sandy Roussin Expires 06.23.2026 v2.pdf
FINANCIAL IMPACT:
Annual Salary For Leah Hennessey: Total $55,000
• 101-11001 Medical Air Transport 78% $42,900
• 141-11500 Fire & Rescue Center 22% $12,100
Annual Salary For Sandy Roussin: Total $57,000
• 101-11001 Medical Air Transport 78% $44,460
• 141-11500 Fire & Rescue Center 22% $12,540
2
SECOND ADDENDUM TO EMPLOYMENT AGREEMENT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS,
THE BOARD OF GOVERNORS OF MONROE COUNTY
FIRE & AMBULANCE DISTRICT 1,AND
DIXIE "SANDY"ROUSSIN
FOR THE POSITION OF EMS BILLING SPECIALIST
THIS SECOND 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 Dixie
"Sandy" Roussin("Employee").
WHEREAS,the County entered into an Employment Agreement("Original Agreement")
with Dixie "Sandy" Roussin on July 12, 2021 for a period of twenty-four (24) months for the
position of EMS Billing Specialist which is due to expire on July 11, 2023; and
WHEREAS, the Employment Agreement allows the parties to extend the employment
term by written addendum; and
WHEREAS,on June 21,2023 the BOCC approved the First Addendum("I"Addenum")
to Employment Agreement which,among other things,extended the employment term for a period
of 24 months commencing July 12, 2023 and terminating on July 11, 2025, and
WHEREAS, due to the hiring of a new EMS Billing Specialist, the County would like to
increase Employee's salary to provide equity across the EMS Billing Specialists based upon
experience and performance; and
WHEREAS,the County desires to extend the term of Ms. Roussin's agreement in order
to make the EMS Billing Specialist Agreement co-terminus.
NOW THEREFORE, in consideration of the mutual promises contained herein, the
County and Employee set forth herein,it is mutually agreed as follows:
Section 1. Paragraph 3(a) of the Original 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's annual salary will
increase from fifty-two thousand dollars ($52,000)to fifty-seven thousand dollars
($57,000).
Billing Specialist Employment Contract
(Dixie"Sandy" Roussin) Page 1 of 2
Section 2. Paragraph 5(a) of the Original Agreement is amended to read as follows: The
normal term of this Agreement as extended by this Addendum will be for a period
of twenty-three(23) months commencing July 14, 2024 and terminating on June
23, 2026.
Section 3. Except as set forth in Sections 1 and 2 of this 2nd Addendum, the terms and
conditions of the Original Agreement dated July 12, 2021 and the I` Addendum
approved June 21, 2023,not inconsistent herewith, remain in full force and effect.
IN WITNESS WHEREOF, the parties have set their hands and seals, in the County of
Monroe, Florida this day of ro 2024.
MONROE COUNTY FIRE RESCUE
DigitaIlysignedbyJamesK.
James K.
Callahan
By ....... ..... .. , .Callahan,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,04'00'024.07.12 11:24:28
James Callahan, Fire Chief
WITNESS: EMPLOYEE
By By:
Dixie"Sandy" Roussin
(SEAL) BOARD OF COUNTY
ATTEST: KEVIN MADOK,CLERK COMMISSIONERS
y, By: ..........................
As Deputy Clerk Mayor
BOARD OF GOVERNORS OF FIRE
COUNTY AND AMBULANCE DISTRICT 1 OF
A FoPAA
� , A�-,64 MONROE COUNTY,FLORIDA
ASSIST 7�
i J.
UNTY A EY
tare 7/12/24
Mayor/Chairperson
Billing Specialist Employment Contract
(Dixie"Sandy" Roussin) Page 2 of 2
MONROE COUNTY
F� ORIIU
Job Description
To perform this job successfully, an individual must be able to perform the essential job functions
satisfactorily. Reasonable accommodations maybe 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.
Jab 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, HCPCS, 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.
• Needsto 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 REPs, 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 otherthan those for which they are regularly scheduled in any capacity
deemed appropriate.
Monroe County,FL Fire Rescue Updated:01/16/2024
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 human 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 handling.
• 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 includingthose
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:01/16/2024
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.
� 1 � �.m„ . � �
Employee Signature Date
Digitally signed by Jernm K.
James K. Callahan cafthan
Date:2024.01.19>>:sae'a-05'W
Supervisor or Director Signature Date
B rya n Cook Da y signed by Bryan Cook
Date:zoza.ni.zz 12:39:12-05'00'
Director of Employee Services Signature Date
l;.o.e. 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