Fire Medical Billing Specialist

Incumbent is responsible for performing medical billing and collection processes for the Goodyear Fire Department including creating, updating, and maintaining accounting spreadsheets; preparing and auditing daily deposits; patient refunds; auditing medical billing and medical charts; reconciling revenue and expenditure reports; and ensuring critical deadlines are met. Incumbent performs quality assurance regarding complete documentation for billing purposes and answers inquiries from insurance companies and patients. Incumbent is responsible for all actions pertaining to the billing, accounting and collections process and will often be tasked with time‑critical projects that entail working with sensitive and confidential information. Examination Process Only a limited number of the most highly qualified applicants meeting the City’s requirements will be invited for an interview. The examination process for this position will include a panel interview and may include a written assessment. All communication regarding application status and interview notifications will be sent via email- please monitor your junk/spam email for communication as messages will come from a system-generated source. Responsibilities Performs a variety of medical billing‑related responsibilities to ensure accuracy of financial data, which may include auditing medical charts and medical billing, preparing patient refunds, collection accounts and deposits; conducts research; determines and raises pertinent issues, summarizes findings and presents results; and administers programs in assigned area. Assists with updating spreadsheets and reports with current fiscal year data, graphs and budget information. Assists with the management of associated special revenue accounts, invoicing, and monthly reconciliations. Researches, compiles, and creates reports and presentations where routine analysis or technical data is required; notifies appropriate individuals of potential problems based upon compiled information and data and recommends potential solutions. Participates in a variety of meetings, briefings, committees, and/or other related groups to provide support in assigned area of responsibility. Qualifications & Requirements Formal Education/Knowledge: Work requires knowledge of a specific vocational, administrative, or technical nature that may be obtained with six months to one year of advanced study or training past the high school equivalency. Community college, vocational, business, technical or correspondence schools are credible institutions. Appropriate certification may be awarded upon satisfactory completion of advanced study or training. Experience: Minimum two years of experience in a related field. Certifications and Other Requirements: None. Reading: Work requires the ability to read policies, procedures, council actions, and city codes at a college level. Math: Work requires the ability to perform math calculations, problem solving and analyzing financials at a college level. Writing: Work requires the ability to write correspondence and procedures to internal and external customers at a college level. Managerial: Job has no responsibility for the direction or supervision of others but role may include overseeing work quality, training, instructing and scheduling work. Policy/Decision Making: Moderate – The employee normally performs the job by following established standard operating procedures and/or policies. There is a choice of the appropriate procedure or policy to apply to duties. More complex work as well as decisions with more significant impacts may be reviewed prior to being finalized. Technical Skills: Broad Application – Work requires a comprehensive, practical knowledge of a technical field with use of analytical judgment and decision‑making abilities. Interpersonal/Human Relations Skills: Moderate – Interactions may involve support of controversial positions or the negotiation of sensitive issues or important presentations. Contacts may also involve stressful, negative interactions requiring high levels of tact and the ability to respond to aggressive interpersonal interactions. EMS Billing Specialist 12‑Month Objectives PHASE I: FOUNDATIONAL KNOWLEDGE (Months 1‑3) Compliance Training Training Objectives: Medicare Ambulance Fee Schedule training. AHCCCS billing guidelines review. Commercial payer requirements overview. CMS documentation standards review. HIPAA Privacy & Security Rules training. Business Associate Agreement (BAA) requirements. False Claims Act overview related to EMS billing. Competency Outcomes: Demonstrate understanding of medical necessity requirements. Understand documentation deficiencies impacting reimbursement. System & Vendor Platform Training Objectives: ImageTrend (ePCR) user training. EMS MC billing software (EMSight) and reporting module training. Contexture/HIE insurance discovery training. Understanding EMS MC claim denial reports. Competency Outcomes: Ability to effectively pre‑bill EMS charts for billing vendor. Independently run billing reports. Identify denial trends within vendor reporting. Trace a claim from transport to reimbursement. PHASE II: OPERATIONAL KNOWLEDGE (Months 4‑6) 3. Documentation Review & QA Training Training Objectives: Shadow vendor claim submission process. Participate in internal chart reviews (EMS CQI). Understand signature, PCS, level of service, and ICD‑10 requirements. Competency Outcomes: Conduct independent internal QA reviews. Identify recurring documentation errors. Finance Training Training Objectives: Munis/Tyler Cashiering software training. Refund process training. Understand reconciliation process & reporting. Check deposit process training. Competency Outcomes: Ability to complete daily deposits received from finance department. Prepare refund packets for submission to finance department for processing. PHASE III: ANALYTICAL & FINANCIAL DEVELOPMENT (Months 7‑9) 5. Financial Metrics & KPI Training Training Objectives: Successfully complete CAC certification. Understand Net Collections Percentage. Understand Clean Claim Rate. Understand Accounts Receivable Aging. Understand differences in reimbursement per transport. Knowledge of third‑party clearing houses & various insurance providers. Competency Outcomes: Identify revenue risk trends. Explain financial impact of documentation errors. Ability to locate EOBs & remittance advice documents successfully. Vendor Oversight & Contract Review Training Training Objectives: Review EMS MC performance standards. Understand service level expectations. Participate in vendor performance meetings. Competency Outcomes: Ability to identify pre‑billing errors. Recommend vendor accountability improvements. PHASE IV: STRATEGIC & LEADERSHIP DEVELOPMENT (Months 10‑12) 7. Process Improvement & Policy Training Training Objectives: Study internal billing SOP. Review CMS updates and regulatory changes. Competency Outcomes: Propose one process improvement initiative. Demonstrate understanding of risk mitigation practices. Customer Service & Escalation Management Training Training Objectives: Develop response protocols for patient escalations. Review de‑escalation communication techniques. Learn documentation standards for high‑risk accounts. Competency Outcomes: Respond to escalated accounts within two business days. Reduce repeat complaint trends. Demonstrate consistent professional communication.

YEAR‑END TRAINING COMPLETION BENCHMARKS

Demonstrate full ambulance billing regulatory knowledge competency. Independently oversee EMS MC denials and appeals. Conduct internal QA audits. Participate in vendor performance discussions. Recommend revenue‑protection and compliance enhancements. #J-18808-Ljbffr City of Goodyear