Temporary - Ambulance Billing and Coding Representative l (Insurance Verification) -EMS

Ambulance Billing And Coding Representative I

The City of Austin's Emergency Medical Services Department provides 9-1-1 emergency medical response to the citizens of Austin and Travis County serving a population of over 2.2M citizens in a service region of over 1,039 square miles. While most of the assistance we give to the community is medical in nature, the smallest part of what we do involves truly time-critical life-threatening emergencies. Yet everything we do is about service: service to our patients, their families and loved ones; service to our community; and service to the people who make up Austin-Travis County Emergency Medical Services. The Ambulance Billing and Coding Representative I will research and verify patient demographic and medical insurance information to ensure accurate billing and proper claim submission. Responsibilities include determining the appropriate primary, secondary, or other responsible party for each ambulance transport; verifying insurance eligibility and coverage through insurance portals; and researching account information using various resources. The position requires strong organizational, problem-solving, and multitasking skills to manage daily skill production while maintaining accuracy. Additional responsibilities include reviewing data for errors, maintaining effective relationships with internal and external customers, providing exceptional customer service, and exercising discretion when handling confidential information.

Job Description

Purpose:

Under limited supervision, using independent discretion and judgement, this position performs advanced-level ambulance billing, recordkeeping, and accounting tasks related to the recovery of revenue for all billable services provided by Austin-Travis County EMS.

Duties, Functions and Responsibilities:

• Receives and answers customer service inquiries, requests, and complaints from the public related to ambulance billing. Responds verbally and in writing while complying with HIPAA, other public record laws, and confidentiality.

• Investigates and gathers information on accounts using a wide variety of resources within the scope of Local, State and Federal laws.

• Daily contact with confidential medical and credit information requiring knowledge and compliance with laws related to the custody, security, and release of this information.

• Reviews pre-hospital care reports for completeness and accuracy of information for billing. Researches and enters patient, financial, diagnostic, and statistical information into billing system.

• Determines order of primary, secondary, or other responsible parties for ambulance fee charges and bills appropriately following Medicare or Medicaid rules.

• Determines appropriate level of care and medical necessity to assign proper diagnosis codes, and charges based on patient care documentation as defined by Centers for Medicare and Medicaid Services (CMS) guidelines.

• Electronically submits healthcare-related forms to payers in accordance with filing deadlines. Prints, reviews, and mails billing statements for claims, and follows up to expedite payment in a timely manner.

• Collects cash and electronic payments. Posts and balances payments on ambulance accounts. Processes refunds and write-offs for management approval.

• Receives and processes rejected or denied claims and initiates appeal process. Works aging reports to optimize cash flow.

• Corresponds verbally and in writing with patients, third-party payers, and insurance carriers on claim denials and past due accounts for resolution of payment issues.

Responsibilities - Supervisor and/or Leadership Exercised:

• None.

Knowledge, Skills, and Abilities:

• Knowledge of medical, insurance, and healthcare terminology.

• Knowledge of medical terminology and general anatomy.

• Knowledge of Local, State, and Federal laws, including HIPAA, Medicare, Medicaid, and other public health plans.

• Knowledge of accounting and bookkeeping practices and concepts, as well as cash handling and account collection procedures and practices.

• Skill in medical coding.

• Skill in insurance verification.

• Skill in establishing and maintaining good working relationships to internal and external customers.

• Skill in using computers and related software applications, multiple line phone systems, credit card machines, and online credit card payment systems.

• Skill in handling multiple tasks and prioritizing.

• Skill in data analysis and problem solving.

• Skill in effective oral and written communication.

• Skill in reviewing (proofreading) material to ensure accuracy, completeness, and adherence to established formats.

• Skill in interpreting and analyzing applicable data.

• Ability to provide exceptional customer service.

• Ability to understand and communicate technical information.

• Ability to exercise discretion in confidential matters.

• Ability to establish and maintain effective working relationships with City employees and the public.

• Ability to work under pressure with frequent interruptions and changes in priorities.

• Ability to manage conflicts and concerns and work with difficult customers.

Minimum Qualifications:

• Graduation from an accredited high school or equivalent, plus two (2) years of experience with medical terminology, medical insurance, and medical billing and coding principles and practices.

Licenses and Certifications Required:

None.

Preferred Qualifications:

• Experience working with the Health and Insurance Portability and Accountability Act (HIPAA) and maintaining confidentiality when handling Personal Health Information (PHI) in a healthcare related setting.

• Familiarity with Medicare, Medicaid, Medicare Advantage, commercial insurance, and managed care plans. Knowledge of insurance billing requirements and payer-specific rules.

• Experience performing insurance eligibility and benefits verification using payer databases, eligibility systems, clearinghouses, and electronic eligibility responses.

• Experience documenting verification results and research findings clearly and consistently.

• Ability to prioritize accounts based on timeliness, filing deadlines, and financial impact. Ability to meet established productivity and accuracy standards.

• Ability to independently verify and validate patient demographic information using multiple sources and not rely solely on automated demographic verification results.

Notes to Candidate

Regarding your application:

• A detailed, complete City of Austin employment application is required to evaluate your qualifications and, if selected as a top candidate for the position, will be used when determining salary.

• Statements like "see resume" will not count when determining experience. Please be thorough in completing the employment application and list all experience that is relevant to this position. The application and resume must include dates (month and year) for each job history entry. In addition, the resume information must match the information on the application.

• Please describe your specific experience as it relates to the minimum and preferred qualifications when responding to the supplemental questions on the application. The responses to the supplemental questions should reference the employment history listed in the employment history section.

• Incomplete applications will not be considered.

• A cover letter and resume are required for this position.

EMS reserves the right to close posted positions prior to the advertised close date, based on recruitment strategies and business needs.

Location: 15 Waller St

Salary Range: $22.05-$24.26

Hours: Monday - Friday 7:30AM-4:30PM

*Fully on-site position

Veterans: Veterans, we thank you for your service and welcome your application. If you are selected as the top candidate for the position, you will be required to provide your DD214.

Internal Applicants: Employees in Good Standing, who are candidates within the Department or division that the position resides in, and who meet the minimum and preferred qualifications for the position will be included in the initial interview.

ATCEMS employees must remain in Good Standing through the Top Candidate Selection phase at which time the Good Standing status will be re-verified.

Please be aware that the Job Posting Close Date reflects the final day to apply, but the posting will close at 11:59 PM the day before the date listed. All application steps, including attachments and submission, must be fully completed before that time.

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