Billing Specialist / EMS

February 04, 2013 - February 19, 2013
Location:Howell, MI
Salary Range:Starting $14.54 / hr.
Exempt/Non-Exempt:Non-Exempt
Benefits:Comprehensive Package Available
Employment Type:Full Time
Department:EMS
Description:Performs a wide range of ambulance billing duties, including preparation of ambulance claims, interacting with numerous insurance companies, including CMS Medicare, Medicaid and BCBS. Serves as the primary point of contact for Livingston County EMS clients regarding the financial component of the ambulance transport.

Duties:Receives and reviews patient care reports and associated documentation from the Paramedics to validate medical necessity based on information provided and carrier specifications. Checks the patient care report for completeness and proper signatures.
Ensure that work is carried out in compliance with all policy and regulatory requirements.
Interpret documentation and medical terminology to verify diagnosis coding and make adjustments as required. Determine defined payer requirements to facilitate claim acceptance and assign appropriate charge codes and modifiers. Provide additional required documentation including certification of medical necessity information, schedules and other items as required for claims processing.
Accurately receives and posts a variety of financial information to accounts and maintains appropriate records.
Responds to questions regarding medical necessity under Medicare and assist patients by providing information regarding the filing of appeals.
Required to be familiar with all relevant laws regarding billing and collections to assist with determining when accounts may go to collections or write-off of charges that pertain to Medicare, Medicaid and all other public health plans.
Reviews rejected Medicare, Medicaid and various insurance claims to determines if they should be appealed or taken to hearing.
Generates requests for refund checks for any overpayment, assuring funds are sent to the correct parties and/or agencies
Responsible for tracking non-signature or incomplete Physician Certification Statements (PCS). Generate and mail letters requesting signatures and document all attempts to get a completed PCS.
Transmit claims electronically and verify confirmation of receipt.
Answer telephone calls, resolve patient inquires, issue statements, insurance bills, and medical records as required within specific operating guidelines.
Expected to protect the privacy of all patient information in accordance with the departmentís privacy policies, procedures, and practices, as required by federal and state law, and in accordance with general principles of professionalism as a health care provider.
May access protected health information and other patient information only to the extent that is necessary to complete the job duties. The employee may only share such information with those who have a need to know specific to patient treatment, payment or other agency operations.
Responds to complaints and questions related to accounts payable; provides information, researches problem and initiates problem resolution.
Processes invoices for payment; matches invoices with statements; verifies receipt of goods/servicesí reviews invoices for accuracy; forwards invoices for payment.
Sorts, organizes, opens, and/or distributes incoming mail; prepares outgoing mail for pickup.
Performs basic office duties, such as copying, filing, faxing, typing standard documents, and entering data.
Qualifications:High School Diploma, or G.E.D., and;
three years of accounts receivable or medical billing experience or an Associate's Degree in Accounting, Administration, Finance or a closely related field; or, an equivalent combination of education and experience sufficient to successfully perform the essential duties of the job such as those listed above.
Certified Ambulance Coder or completion within 1 year of hire.


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