MEDICAL UTILIZATION COORDINATOR - FULL TIME

Job Description

Job Description

Essential Duties and Responsibilities:

• Pre-Billing inclusive of but not limited to Charts, Insurance Verification, and collection of needed documentation.
• Work with Medical Utilization Officer on repetitive patient accounts. This will include maintaining current PCS forms and documents needed for billing to obtain prior authorization.
• Daily review of fax/scanned medical necessity forms, and attachment of those forms to patient records in CAD.
• Work with field management staff to obtain patient assessments when needed.
• Communicate with customers in a professional manner.
• Interact with payers to secure timely payment information and/or pre-authorization.
• Verify payor coverage through resources available.
• Maintain knowledge of payor regulations including need for pre-authorizations.
• Represent the organization professionally and appropriately.
• Ability to work in and participate in a team environment

Non-Essential Duties and Responsibilities

• Perform other duties as assigned.

Physical Requirements- (Field Employees Only)

• N/A

Minimum Qualifications:

• Able to work independently.
• High level computer skills.
• Excellent interpersonal skills.
• Service oriented.

Education/Licensing/Certification:

• (Preferred) Have one (1) year EMS dispatch experience.
• (Preferred) Be a currently state certified EMT
• High school diploma or GED
• Current state driver’s license.

Other Knowledge and Skills:

• Maintains professional competence and demonstrates concern for the competence of other members of the EMS health care team.
• Maintain HIPAA Compliance.
• Strong ability to multi-task at a high pace environment.
• Ability to uphold standards of practice and education.
• Ability to adhere to standards of personal ethics, on and off duty, which reflect credit upon the profession.
• Does not use professional knowledge and skills in any enterprise detrimental to the Company or to the public well-being.
• Ability to respect and hold in confidence all information of a confidential nature obtained in the course of professional work unless required by law to divulge such information.
• Has good working knowledge of all company policies pertaining to this position.
• Good knowledge of common physical illnesses, obvious symptoms, and medical terminology.

Equal Employment Opportunity (EEO) Statement  

Pafford EMS is an Equal Opportunity Employer. We are committed to creating an inclusive environment for all employees and applicants for employment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic under applicable federal, state, or local law.

We believe that diversity strengthens our team and enhances our ability to serve the communities in which we operate.

**PLEASE NOTE: Pafford Emergency Medical Services reserves the right, at the discretion of the appropriate appointing authority, to waive any of the minimum qualifications for those applicants whose general or specific qualifications would otherwise qualify the applicant for the position or lead the appointing authority to believe that the applicant is capable of performing the assigned duties and fulfilling the assigned responsibilities.