Medical Biller/Coder - Empress EMS
Poughkeepsie, NY
About the Job
Summary
Responsible for knowing, understanding, and following Insurance billing regulations for Non-Emergency and Emergency Ambulance billing. Running and providing department reports for monitoring purposes. Completing and maintaining projects assigned for Medicare/Medicaid.
Key Responsibilities
· ResponsibleforALLaspectsofBillingandCollectionsfor911and Non-EmergencyAmbulanceService ProvidersuchasMedicare,Medicaid,insurancedenials.
· Liaisonbetweenseniormanagement,employees,andclientstoensureproperlinesofcommunicationcriticalin addressingamyriad ofproblemsandissuesrequiringimmediateattentionandresolve.
· Provide generaladministrativeandclericalsupportincludingbutnotlimitedto receiving,maintainingmedicalrecords,faxing,copying &scanning.
· Responsiblefortrainingandcoachingteammembersonnewand/orexistingprocedures.
· Responsible for daily/ weekly & monthly reporting of following reports & Medicare application compliance items.
· Attending industry Webinars/ Conferences and preparing summary to ensure we are up to date with industry & billing compliance standards.
· Responsible for reviewing PCS forms to expedite claim submission & collections.
· Submitting RR Medicare record requests.
· Work closely with Department Managers/ Supervisors to create improvement & implement processes to ensure department goals and objectives are met on in a consistent basis.
· Submitting Medicare appeal via Medicare online portal to expedite payment.
· Review weekly CDI lists to ensure accounts are updated timely in effort to expedite claim submission & payment.
· Work on Medicare/ Medicaid denials to Identify trends & expedite claims processing & payment.
· Responsible for completing department projects as assigned that will assist in trend analysis, compliance & revenue improvement.
POSITION QUALIFICATIONS
Education & Experience
- High School Diploma, Associate degree preferred.
- Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC) preferred.
- Extensive Medicare and Medicaid experience and understanding medical necessity in ambulance transportation.
- Ambulance/Medical billing certification or diploma preferred.
- Maintain working knowledge of ICD-10, CPT and HCPCS coding, NPI, HIPAA, Modifiers, EPCR’s andallformsofmedicalbilling(direct,3rdparty,HMO’s,privatepay,no-fault,worker’scomp,Medicare& Medicaid
- Excellent organizational skills and the ability to multi-task in a fast-paced environment
- Review and research data; use intuition and experience to complement data.
- Thorough knowledge of transport documentation (PCRs)
- Ability to follow up on outstanding Medicare accounts.
- Ability able to submit appeals and overpayment requests.
- Familiar with Medicare/CMS requirements and guidelines.
- Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance.
- Excellent written and verbal communications skills required · Excellent documentation skills (promptness, accuracy, thoroughness, and legibility).
· PCS/ Medical necessity.
· Customer Service/ Client relations.
Competencies
- Working knowledge of EMS systems/private ambulance and medical transportation systems preferred.
- Knowledge of CONNEX preferred.
- Knowledge Microsoft Word, Microsoft Excel, and Microsoft Windows.
- Familiarity with medical terminology
- Organizational and leadership abilities, detail oriented.
Work Environment
- Work is performed under normal working conditions, as in a standard office environment.
Physical Requirements
- High level of sitting/working at a desk
- Light physical effort (lift/carry up to 10 lbs.)
- Must be able to perform the essential duties of the position with or without reasonable accommodations.