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)” *

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 specialized, technically oriented position is on meeting and exceeding high standards of accuracy and quality based on established systems, technologies and guidelines. Strength in technical problem solving based on expertise and experience, and a strong commitment to efficiently achieve high quality results is required. A thoughtful, persevering, self-disciplined approach to achieving accurate, detailed work is essential. Job responsibilities and expectations are clearly defined, as is the scope of job authority. Expertise and competency is developed a systematic technical training program, as well as in ongoing exposure to and training in new technical systems once they have been adopted and well tested. A key aspect of the job includes the ongoing identification of technical problems and the development of sound, carefully thought-out solutions. Problem solving is focused on proven systems and technologies and established organizational relationships. Solutions should minimize risk to the organization and utilize existing resources. Because of the expertise developed in this position, it is necessary to regularly initiate and communicate viewpoints on problems and opportunities in a factual, straightforward manner. This job allows for autonomy and independence, and is primarily self-reliant. Because of the fast paced job environment, decisions must be made quickly and firmly, within the defined scope of job.

ESSENTIAL DUTIES and RESPONSIBILITIES:

The Accounts Receivable Specialist will perform the following functions on a daily basis as a part of their normal duties:

• Manage all claims over 90-days on the A/R reports in a timely manner
• Work assigned denials and correspondence within 2 business days of receipt
• Report all trends detected in A/R management
• Prepare corrected claims and appeals, as needed
• Received inbound and Make outbound calls as needed to insurance carriers and patients
• Follow all state and federal collections and HIPAA laws
• Other duties as assigned

KNOWLEDGE AND EXPERIENCE REQUIRED:

• • Maintain any certification applicable to job functions
  • Computer Literacy
  • Ability to communicate effectively and in a professional manner with patients, insurance carriers, co-workers, management and others
  • Detail Oriented
  • Knowledge of managed care plans, insurance, medical terminology
  • Knowledge of reimbursement fee schedules (Medicare and Medicaid)
  • Knowledge of refund processes and requirements
  • Ability to establish/maintain cooperative working relationships with staff
  • Ability to prioritize and multi-task

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