EMS Revenue Specialist

Superior Air-Ground Ambulance Service•Elmhurst, IL

9d•Onsite

About The Position

The EMS Revenue Specialist works directly with health insurance companies to resolve open balances. The role may involve using payer portals to check claim status, updating patients’ insurance policies, reviewing or updating ICD-10 codes, and sending corrected claims or appeals. Representatives conduct insurance verification as needed and must complete prebilling training to qualify for the role. The specialist handles patient and insurance billing questions, researches and audits accounts, resolves denials and discrepancies, calculates adjustments based on EOBs, remittances, and insurance contracts, and communicates with callers including customers, agencies, facilities, and hospitals. The role requires accurate data entry, attention to detail, compliance with applicable billing requirements, and the ability to work independently and as part of a group. This position is based in an office environment and requires sitting or standing for at least eight hours. The specialist uses two monitors and split screens to work across multiple sites and uses standard office and communication software.

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 how to work accounts.
Computer literacy.
Ability to work with two monitors and split screens to operate multiple sites simultaneously.
Ability to sit or stand for at least eight hours in an office environment.
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.
Excellent verbal communication skills and ability to communicate with clients, insurance companies, patients, staff, and management.
Ability to manage multiple tasks, meet deadlines, and handle periods of high call volume and stress.
Strong attention to detail and accuracy.
Positive, motivated, quick-learning approach, good judgment, and ability to escalate accounts when needed.
Ability to receive and implement feedback.

Nice To Haves

College education is preferred.
Healthcare knowledge is preferred.
Typing speed of at least 45 words per minute is highly desired.
Experience working in an active office environment.

Responsibilities

Place and receive calls regarding insurance billing questions and other patient service activities.
Process accounts using the appropriate actions to resolve outstanding balances.
Resolve insurance carrier denials, appeal claims, contact carriers about open accounts, and respond to carrier correspondence and inquiries.
Communicate effectively with callers, including customers, agencies, facilities, and hospitals, and use one-step resolution practices for clients and patients.
Research patient accounts to verify health insurance coverage.
Audit patient accounts to verify that proper billing processes were followed.
Calculate adjustments based on EOBs, remittances, and insurance contracts.
Maintain accurate data entry and consistent attention to detail.
Collect outstanding balances and identify, address, and resolve account discrepancies in accordance with company policies and procedures.
Demonstrate knowledge of and compliance with insurance and local, state, and federal billing requirements.
Complete tasks efficiently both independently and in a group environment.
Handle assigned correspondence and other duties as assigned by managerial staff.
Complete insurance verification as needed and prebilling training required to qualify for the role.

Benefits

Opportunities for career advancement
Competitive wages
On-demand pay before payday
401(k) with company contribution
Medical, dental, vision, and life insurance
Voluntary short-term disability, critical illness, accident, and legal insurance
Company-paid life insurance and long-term disability
Paid vacation and sick time
Holiday pay
Referral bonus