2nd Amendment 07/12/2024 �OOURT¢�111.
yJ° °G'... d Kevin Madok, CPA
*' Clerk of the Circuit Court&Comptroller-Monroe County, Florida
ECOV ter.
DATE: July 25, 2024
TO: Cheri Tamborski
Emergency
Services
Mayor Bruce Halle
Fire & Ambulance District 1 Board of Governors
FROM: Liz Yongue, Deputy Clerk
SUBJECT: July 17, 2024 BOCC Meeting
The following item has been executed and added to the record:
C21/H1 Ratification by the BOCC & BOG of an Employment Agreement with
•Leah Fennesseyhired to fill a vacancy as a Monroe County Fire Rescue(MCFR) EMS y y • � Billing
Specialist with an annual salary of$55,000, commencing on June 2024 and expiring on June
24,
23, 2026; and authorizing the County Administrator/Fire Chief to execute all necessary
documents.
Ratification by the BOCC & BOG 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 July 14,2024 and:expiring on June 23,2026;and
authorizingthe County Administrator/Fire Chief to execute all necessary documents:
Should you have any questions, please feel.free.to contact me at(305) 292-3 5 50.
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
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 1 3t 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
onroe, Florida this FV " day of 2024.
C.,) Ce)- - MONROE COUNTY FIRE RESCUE
.:i..�.a Digitally signed by James K
Ja I I I K. Callahan
.. :; Date:2024.07.12 11:24:28
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E. c... James Callahan, Fire Chief
Lu ", g.
...
ITNESS: EMPLOYEE
Bye i By: ___
1 Dixie"Sandy" Roussin
.-, j;.4 J v -..tom,°:`:':`,
' ,--_r_-__ �SEAL� y ,,1, BOARD OF COUNTY
"�: ` ^p, ° �TT�EST XE COMMISSIONERS
._,� j •,!. .. r':• MADOK,CLERK
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`,, -y .;�;,,r-:, .s.L -1" Ai Deputy Clerk Mayor
BOARD OF GOVERNORS OF FIRE
i1 Faou AT AND AMBULANCE DISTRICT 1 OF
i-e-e., r.,,„,,, MONROE COUNTY,FLORIDA
Date 7/12/24 44.1.0"....1/0e—
Bv'•
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