Overview:
EMS Revenue Specialist
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.
All representatives will conduct insurance verification as needed and are required to complete prebilling training to qualify for the role.
Responsibilities:
Responsibilities of the EMS Revenue Specialist
- 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.
Key Skills of the EMS Revenue Specialist
- Well-versed with medical billing practices that include an understanding of insurance billing codes, regulations, and procedures.
- Ability to investigate and resolve software issues, billing errors and disputes.
- Effective communication skills with clients, insurance companies, patients, staff members and management.
- Ability to manage multiple tasks and meet deadlines.
- Must have great attention to detail with high accuracy.
Qualifications:
Qualifications of the EMS Revenue Specialist
- 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.
- 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.
Benefits
- Opportunities for career advancement
- Competitive wages
- Ability to receive on demand pay before pay day
- 401(k) with company contribution
- Medical, Dental, Vision & Life Insurance
- Voluntary Insurance (short-term disability, critical illness, accidental & legal)
- Company Paid Life Insurance and Long-Term Disability
- Paid vacation & sick time
- Holiday pay
- Referral bonus available
Salary or Wage Range:
USD $21.00 - USD $26.00 /Hr. rates offered based on years of experience