Billing Resolution Specialist I - Digitech - Remote
About The Position
The Billing Resolution Specialist (BRSI) plays a critical role in Digitech’s RCM process by ensuring claims are coded and billed accurately and in a timely manner. The BRSI must maintain a strong working knowledge of billing rules and regulations for all payor types across the various regions in which they process claims. This role requires strong attention to detail and a commitment to the highest quality standards. The BRSI is primarily focused on resolving any issues that prevent a claim from being released to the appropriate payor. Maintaining the highest billing standards is essential to Digitech achieving its overall quality goals and vision: to be the trusted partner of choice that 100% of our clients would recommend to a friend or colleague.
Requirements
- High School Diploma or equivalent
- 3+ years EMS Billing preferred
- Certified Ambulance Coder (CAC) preferred
- Demonstrated ability or willingness to attain QMC Biller Certification upon employment
- Highly detailed-oriented
- Proficient in Excel functions such as filters, pivot tables, and conditional formatting
- Strong working knowledge of EMS billing rules and regulations, and a clear understanding of health insurance payor groups (Medicare, Medicaid, Commercial)
- Ability to identify problems and escalate issues appropriately to leadership
- Ability to quickly adapt to, learn, and retain changing client, payor, state, and MAC region rules and specifications
- Quality-focused and process-driven
- Excellent problem-solving skills
- Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment
Responsibilities
- Perform post-billing review for eligible/valid patient or other applicable signatures to release claims for payment
- Conduct post-billing review for third-party liability coverage
- Review hospice-related claims to determine the appropriate payor
- Review insurance information captured after initial billing to determine the correct payor
- Submit new and corrected claims through online payor portals
- Perform quality assurance reviews of claims processed by other segments
- Attend and actively participate in team huddles and other required meetings
- Consistently meet or exceed production goals while maintaining high-quality work
- Provide timely feedback to leadership based on tasks worked
- Maintain a high level of compliance with all regulatory requirements and internal policies and procedures
- Adhere to all Digitech HIPAA privacy policies and procedures. This includes always maintaining the confidentiality and security of sensitive patient information
- Additional job duties as assigned
Benefits
- 401(k) Plan
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
