Billing Resolution Specialist

Role Description

The Billing Resolution Specialist (BRSI) plays a critical role in Digitech’s RCM process by ensuring claims are coded and billed accurately and in a timely manner. The BRSI must maintain a strong working knowledge of billing rules and regulations for all payor types across the various regions in which they process claims. This role requires strong attention to detail and a commitment to the highest quality standards. The BRSI is primarily focused on resolving any issues that prevent a claim from being released to the appropriate payor. Maintaining the highest billing standards is essential to Digitech achieving its overall quality goals and vision: to be the trusted partner of choice that 100% of our clients would recommend to a friend or colleague.

• Perform post-billing review for eligible/valid patient or other applicable signatures to release claims for payment
• Conduct post-billing review for third-party liability coverage
• Review hospice-related claims to determine the appropriate payor
• Review insurance information captured after initial billing to determine the correct payor
• Submit new and corrected claims through online payor portals
• Perform quality assurance reviews of claims processed by other segments
• Attend and actively participate in team huddles and other required meetings
• Consistently meet or exceed production goals while maintaining high-quality work
• Provide timely feedback to leadership based on tasks worked
• Maintain a high level of compliance with all regulatory requirements and internal policies and procedures
• Adhere to all Digitech HIPAA privacy policies and procedures, maintaining the confidentiality and security of sensitive patient information
• Additional job duties as assigned

Qualifications

• High School Diploma or equivalent
• 3+ years EMS Billing preferred
• Certified Ambulance Coder (CAC) preferred
• Demonstrated ability or willingness to attain QMC Biller Certification upon employment
• Highly detail-oriented
• Proficient in Excel functions such as filters, pivot tables, and conditional formatting
• Strong working knowledge of EMS billing rules and regulations, and a clear understanding of health insurance payor groups (Medicare, Medicaid, Commercial)
• Ability to identify problems and escalate issues appropriately to leadership
• Ability to quickly adapt to, learn, and retain changing client, payor, state, and MAC region rules and specifications
• Quality-focused and process-driven
• Excellent problem-solving skills
• Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment

Benefits

• Competitive salary, commensurate with experience
• Comprehensive benefits package, including 401(k) Plan

Company Description

Sarnova is an Equal Opportunity Employer. Our mission is to be the best partner for those who save and improve patients’ lives. Excellence in delivering upon our mission is dependent upon having a diverse team that is empowered to bring their full, authentic self to work each day. We strive to create a workplace that reflects the communities we serve, and we are passionate about creating an inclusive workplace that promotes and values diversity.