Performs day-to-day billing/follow-up activities required to get final resolution and collect on outstanding accounts receivables (AR) from patients and insurances.
Essential Duties and Responsibilities:
- Processes billing/follow-up functions to increase cash collections and decrease AR (i.e., checks claim status, responds to additional documentation requests, confirms insurance eligibility, updates patient demographics, authorizations, payer, and ICD-10 coding).
- Identifies claims processing issues and works through them for claims resolution.
- Expedites and maximizes payment of claims by contacting and following-up with communications to and from payers and patients via phone, online portals, email, fax, and mail.
- Performs claim negotiations and appeals.
- Processes denials and works down AR.
- Utilizes all available resources (i.e., explanation of benefits, payer/vendor websites), to ensure claims are adjudicated correctly.
- Updates billing system to ensure that follow-up actions are properly documented.
- Completes detailed forms and reports accurately.
- Meets daily/monthly department goals.
- Manages changes in priorities based on business need.
- Ensures compliance with State and Federal guidelines.
- Possesses knowledge of payer specific guidelines.
- Performs additional duties as assigned.
Minimum Qualifications and Requirements:
- High school graduate (or GED)
- Two years’ experience in EMS and/or Ambulance Revenue Cycle follow up processes required.
- Experience working with Medicare, Medicaid and Commercial Insurances preferred.
- Must be able to read, write and speak English.
- Excellent documentation skills.
- Outstanding interpersonal and communication skills.
- Must portray a positive company image.
- Must be computer literate (i.e., experience working with Excel, Word, etc.).
- Ability to work with minimal supervision, following guidelines and company policy.
- Collect, interpret, and/or analyze complex data and information.
- Regular attendance and timeliness.
- Good multi-tasking and critical thinking skills.
- Must be able to sit for an extended period.
- Frequent repetitive hand movements, standing, walking, reaching, and grasping.
- Must be able to hear and communicate clearly to perform job duties in person and remotely.
- Adequate vision required to be able to read information from printed sources and computer screens.