Overview

The EMS Revenue Specialist is responsible for working directly with the Health Insurance Companies to resolve open balances. This could include but not limited: utilizing payer portals to check claim status, updating patients’ insurance policy, reviewing / updating the ICD-10 code listed, sending corrected claims and/or appeals.

Responsibilities

• Places and receives calls regarding billing insurance questions and other patient service activities.

• Process accounts according to the action required to resolve account balances.

• Resolving insurance carrier denials, appealing claims, contacting carriers on open accounts, and responding to insurance carrier correspondence and/or inquiries.

• Comfortable communicating with any caller including customers, agencies, facilities, and hospitals.

• Employ one-step resolution practices for clients and patients through open lines of communication.

• Research patient accounts to verify all health insurance coverages. Audit patient accounts to verify proper billing process was followed.

• Compute adjustments based on EOB's remittance and insurance contracts.

• Ensure accuracy in data entry and consistent attention to detail.

• Collect outstanding balances as well as identify, address, and resolve account discrepancies while following company policy and procedures.

• Demonstrates knowledge and compliance of insurance, local, state, and federal billing.

• Ability to complete tasks efficiently both individually and in a group environment.

• Handle assigned correspondence fulfilling any other duties as assigned by managerial staff.

Qualifications

• College preferred but not required.

• Minimum two years’ experience in customer care, account management or similar role.

• Ability to read and understand the Explanation of Benefits or Electronic Remittance Advice.

• Understands the difference between rejections and denials as well as working accounts.

• Healthcare knowledge is preferred.

• Must be a quick learner and motivated individual with excellent verbal communications skills.

• Fluency in second language is a plus, Spanish preferred.

• Ability to “Multi-task” and manage spurs of high call volume / stress.

• Positive, can-do attitude and with good judgement demonstrating ability to escalate account when needed.

• Ability to receive and implement feedback.

  Computer and Office Qualifications of the EMS Revenue Specialist

• Computer literacy is a must; Typing skillset of at least 45 WPM is highly desired

• Experience working in an active office environment.

• Must be able to work with 2 monitors and split screens to operate multiple sites simultaneously.

• Must be able to sit / stand for 8 hours minimum in an office environment

• Must be able to use Word, Excel Spreadsheet, Email, Chat Applications, and other software applications.

• Must be able to read, comprehend, and apply job-related rules, policies, and procedures.

  Paramedic Billing Services, is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.