Billing & Collections Specialist

Billing SpecialistTitle: Billing SpecialistPafford EMS: Hempstead CountyDivision/Department: PMBSState: ArkansasEssential Duties and Responsibilities:Obtain referrals and pre/post-authorizations for ambulance servicesCheck eligibility and benefits verificationReview insurance and facility claims for accuracy and completenessPrepare, review, and transmit claims using billing software, clearinghouse, and payer websitesFollowing up on unpaid claims within standard billing cycle timeframeReviewing underpaid claims for appropriate escalation steps to ensure appropriate reimbursement for servicesCalling insurance companies regarding any payment discrepanciesIdentifying and billing secondary or tertiary insuranceProcessing incoming mail and taking appropriate follow up actions to resolve accountsResearching and appealing denied claimsAnswering all patient or insurance telephone inquiriesContacting the patient to escalate issues with the insurance companiesMaintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)Performing other duties as assigned.Qualifications:Proficient with a PCKnowledge of Health Insurance Portability and Accountability Act (HIPAA)Knowledge of procedure and diagnostic codes (HCPCS and ICD-10 codes)Knowledge of medical terminologyKnowledge of Medical BillingKnowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and commercial payersCustomer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgroundsProblem-solving skills to research and resolve discrepancies, denials, appeals, and collectionsAbility to work independently and with a groupWorking knowledge of MS Word, ExcelAbility to maintain effective working relationshipsThorough knowledge of office practicesAbility to type at least 35 words per minuteProficiency using 10 keyEducation and Experience Requirements:High School Diploma or GEDMinimum of one year revenue cycle management experience or related experiencePhysical Requirements:Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standardsAbility to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standardsThe employee may occasionally be required to lift and/or move up to 20 poundsSpecific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focusWork may require sitting, lifting, stooping, bending, stretching, walking, standing, pushing, pulling, reaching, and other physical exertionMust be able to talk, listen and speak clearly on telephoneMust possess visual acuity to prepare and analyze data and figures, operate a computer terminal, and operate a motor vehicleTravel Time: Negligible