PRIMARY FUNCTIONS:

The Pre-Billing Specialist is responsible for ensuring accurate patient demographic and insurance information is reported in each claim.

REPORTS TO:

The Pre-Billing Specialist reports directly to the appropriate Billing Manager and works collaboratively with other Emergicon personnel in all departments.

ESSENTIAL DUTIES and RESPONSIBILITIES:

• Request hospital face sheet/demographics if applicable to obtain payer/demographic information
• Verify payer information and select/add appropriate payer information on all transports
• Check appropriate insurance web-sites and/or contact the patient on all private pay accounts prior to billing
• Review PCR or face sheets for missing insurance and other pertinent information in relation to billing
• Work and resolve any claim for which a denial was received
• Follow up on rejected claims
• Work returned mail
• Other duties as assigned

KNOWLEDGE AND EXPERIENCE REQUIRED:

• High School diploma required
• One year data entry skills preferred
• Computer literate and enjoys working in search programs to find information
• Problem solving mindset
• Insurance verification knowledge
• Well organized and detail oriented
• Professional phone skills
• Maintain any certification applicable to job functions
• Ability to handle multiple tasks and to prioritize their importance

ADDITIONAL INFORMATION

The competence of the employee in performing his/her job duties is evaluated during the introductory period to his/her position and will be demonstrated, maintained and improved on an ongoing basis.  The statements contained in the position reflect the general duties considered necessary to describe the principle functions of the job identified, and shall not be considered a detailed description of all the work requirements that may be inherent in the position.

The focus of this job is on producing high quality, detailed work based on established standards, guidelines and procedures. Precise, consistent work output is essential requiring patience and a willingness to handle and complete one task at a time. The job environment is stable, based on known relationships with people and well-defined processes. Job knowledge and competency is built through structured step-by-step training and positive, supportive coaching from management and peers. Communication with others is based on knowledge of repetitive job routines and procedures gained from sufficient on the job experience. Consistent, error free work based on defined regulations and standards are key measures of job performance success. This position is designed to develop a valued technical expert, who, recognized and supported by management and a stable work environment, can deliver quality work on a consistent basis. Must be able to work in a fast paced environment.

ESSENTIAL DUTIES and RESPONSIBILITIES:

The Billing Specialist will complete the following functions on a daily basis:

• Obtain all run reports (trip notes, PCR’s, etc.) by paper or electronically for previous day’s transports
• Code claims with appropriate ICD-10 & HCPC codes
• Review each chart for medical necessity
• Request hospital face sheet/demographics if applicable to obtain payer/demographic information
• Verify payer information on all transports
• Check appropriate insurance web sites and/or contact the patient on all private pay accounts prior to billing
• Enter all claims into billing system
• Match claims billed against all appropriate logs
• Resolve all incoming patient and client telephone calls as needed
• Follow up on rejected claims and failed claims as needed
• Recognize payor trends and report to management
• Other duties as assigned

KNOWLEDGE AND EXPERIENCE REQUIRED:

• High School diploma required
• Six months of medical billing experience preferred
• CAC preferred
• Detail oriented
• Strong verbal communication and written skillset

* If you are selected as potential candidate we’ll send you an assessment to complete (please check your junk mail)” *