EMS Revenue Specialist

Paramedic Billing Services•Elmhurst, IL

11d•$21 - $26

About The Position

The EMS Revenue Specialist works directly with health insurance companies to resolve open balances. Duties may include using payer portals to check claim status, updating patients’ insurance policies, reviewing or updating ICD-10 codes, and submitting corrected claims or appeals. Representatives also conduct insurance verification as needed and must complete prebilling training to qualify for the role. The position involves processing patient accounts, resolving insurance denials and billing discrepancies, communicating with patients and other callers, researching coverage, auditing billing, calculating adjustments, and collecting outstanding balances. The specialist must follow company policies and applicable insurance and local, state, and federal billing requirements, while completing work accurately and efficiently in both individual and group settings. The role requires computer literacy and work in an active office environment. The employee must be able to use two monitors and split screens, work with common office and communication applications, and sit or stand for at least eight hours. College education is preferred but not required; at least two years of customer care, account management, or similar experience is required.

Requirements

At least two years of experience in customer care, account management, or a similar role.
Ability to read and understand an Explanation of Benefits (EOB) or Electronic Remittance Advice (ERA).
Understanding of the difference between claim rejections and denials and experience working accounts.
Computer literacy and ability to use Word, Excel spreadsheets, email, chat applications, and other software applications.
Ability to read, comprehend, and apply job-related rules, policies, and procedures.
Ability to sit or stand for at least eight hours in an office environment.
Ability to work in an active office environment.
Ability to manage multiple tasks, meet deadlines, and handle high call volume and stressful periods.
Strong attention to detail and accuracy.
Effective verbal communication skills and sound judgment, including the ability to escalate accounts when needed.
Ability to learn quickly, stay motivated, and receive and implement feedback.
Ability to complete tasks efficiently both individually and as part of a group.

Nice To Haves

College education is preferred but not required.
Healthcare knowledge is preferred.
Typing speed of at least 45 WPM is highly desired.

Responsibilities

Place and receive calls about insurance billing questions and other patient service matters.
Process accounts according to the actions needed to resolve account balances.
Resolve insurance carrier denials, appeal claims, contact carriers about open accounts, and respond to carrier correspondence and inquiries.
Communicate with customers, agencies, facilities, hospitals, patients, insurance companies, staff, and management.
Use open communication and one-step resolution practices for clients and patients.
Research patient accounts to verify health insurance coverage and audit accounts to confirm proper billing procedures were followed.
Calculate adjustments based on EOB remittances and insurance contracts.
Maintain accurate data entry and attention to detail.
Collect outstanding balances and identify, address, and resolve account discrepancies in accordance with company policies and procedures.
Comply with insurance and local, state, and federal billing requirements.
Complete assigned correspondence and other duties as assigned by managerial staff.
Complete insurance verification as needed and prebilling training required to qualify for the role.
Use two monitors and split screens to operate multiple sites simultaneously.