EMS Revenue Specialist

Overview

EMS Revenue Specialist

The EMS Revenue Specialist is r esponsible for working directly with the Health Insurance Companies to resolve open balances . This could include but not limited: u tilizing p ayer portals to check claim status, u pdating patients’ insurance policy, reviewing / updating the ICD-10 code listed, sending corrected claims and/or appeals .

All representatives will conduct insurance verification as needed and are required to complete prebilling training to qualify for the role.

Responsibilities

Responsibilities of the EMS Revenue Specialist

• Places and receives calls regarding billing insurance questions and other patient service activities.

• Process accounts according to the action required to resolve account balances.

• Resolving insurance carrier denials, appealing claims, contacting carriers on open accounts, and responding to insurance carrier correspondence and/or inquiries.

• Comfortable communicating with any caller including customers, agencies, facilities, and hospitals.

• Employ one-step resolution practices for clients and patients through open lines of communication.

• Research patient accounts to verify all health insurance coverages. Audit patient accounts to verify proper billing process was followed.

• Compute adjustments based on EOB's remittance and insurance contracts.

• Ensure accuracy in data entry and consistent attention to detail.

• Collect outstanding balances as well as identify, address, and resolve account discrepancies while following company policy and procedures.

• Demonstrates knowledge and compliance of insurance, local, state, and federal billing.

• Ability to complete tasks efficiently both individually and in a group environment.

• Handle assigned correspondence f ulfill ing any other duties as assigned by managerial staff .

Key Skills of the EMS Revenue Specialist

• Well-versed with medical billing practices that include an understanding of insurance billing codes, regulations, and procedures.

• Ability to investigate and resolve software issues, billing errors and disputes.

• Effective communication skills with clients, insurance companies, patients, staff members and management.

• Ability to manage multiple tasks and meet deadlines.

• Must have great attention to detail with high accuracy.

Qualifications

Qualifications of the EMS Revenue Specialist

• College preferred but not required .

• Minimum two years’ experience in customer care, account management or similar role .

• Ability to read and understand the Explanation of Benefits or Electronic Remittance Advice.

• Understands the difference between rejections and denials as well as working accounts.

• Healthcare knowledge is preferred .

• Must be a quick learner and motivated individual with e xcellent verbal communications skills .

• Ability to “ multi-task ” and manage spurs of high call volume / stress .

• Positive, can-do attitude and with good judgement d emonstrating ability to escalate account when needed.

• Ability to receive and implement feedback .

Computer and Office Qualifications of the EMS Revenue Specialist

• Computer literacy is a must; Typing skillset of at least 45 WPM is highly desired

• Experience working in an active office environment.

• Must be able to work with 2 monitors and split screens to operate multiple sites simultaneously.

• Must be able to sit / stand for 8 hours minimum in an office environment

• Must be able t o use Word, Excel Spreadsheet, Email, Chat Applications, and other software applications .

• Must be able to read, comprehend , and apply job-related rules, policies, and procedures .

Benefits

• Opportunities for career advancement

• Competitive wages

• Ability to receive on demand pay before pay day

• 401(k) with company contribution

• Medical, Dental, Vision & Life Insurance

• Voluntary Insurance (short-term disability, critical illness, accidental & legal)

• Company Paid Life Insurance and Long-Term Disability

• Paid vacation & sick time

• Holiday pay

• Referral bonus available

Salary Range

USD $21.00 - USD $26.00 /Hr. rates offered based on years of experience