Medical Billing Specialist I (A262913-2), 202, Ambulance

City of Laredo•Laredo, TX

7d•Onsite

About The Position

Handles new claims, posting payments, and appeals of lower complexity. Provides customer service and processes medical and billing record requests. Reviews, generates, and processes emergency ambulance transport medical claims. Determines appropriate CPT and ICD 10 codes based on the medical data and narrative furnished in ePCR (electronic Patient Care Report) and if additional medical information of ePCR is needed to bill accordingly. Serves as additional support staff to manage the numerous amount of medical claims that come from EMS related services. Retrieves hospital face sheets to obtain health insurance information and reviews and researches additional health insurance portals, if necessary. Determines primary, secondary, and/or tertiary insurances sequences based on insurance coverage per patient. Submits CMS1500 forms when necessary. Transmits electronic claims and reviews transmission reports for accepted and rejected claims. Responsible for reviewing claim batches to ensure they cleared the billing system and the clearinghouse's claim checks. Reviews medical and billing record requests in response to subpoenas, attorneys, hospitals, insurances, record retrieval companies, and other companies or organizations. Prepares, invoices, and submits all medical and billing record and affidavit requests to respective parties. Provides customer service to patients in person and/or by telephone and is responsible for resolving the reason for visit or call. Is responsible for taking payments, in person or over the phone. Reviews incoming correspondence and distributes accordingly. Assists in daily work assignments of lower complexity and any other clerical work assigned by the program supervisor. Will be required to drive a City vehicle for City business use. Performs other duties as assigned.

Requirements

Knowledge in ICD-10, CPT, and HCPCS medical coding
Knowledge in Medicare and Medicaid guidelines
Knowledge in health insurance claim submission and collections
Knowledge of HIPAA guidelines
Knowledge of complex medical office clerical and billing services and operations
Ability to solve mathematical problems pertaining to patient accounts and billing functions
Ability to build and maintain effective working relationships with others
Ability to communicate clearly and effectively both orally and in writing
Ability to maintain good planning and organizational skills
Ability to take and follow directions from supervisor
Ability to give directions to and gain compliance from assigned staff
Ability to maintain a valid Texas Driver License and a good driving record
Ability to project a positive and professional image of the City of Laredo
Ability to effectively communicate both orally and in writing in the English language and orally in the Spanish language
Ability to comply with all City of Laredo's policies and procedures
Ability to maintain good health and physical condition sufficient to permit the full performance of the duties of this position
High School Diploma or G.E.D.
At least six (6) months of experience in medical coding, working with Medicare or Medicaid, working with insurance claims, or clerical experience in a medical office.
Proof of TB Test/Screening will be required to be presented prior to employment
Valid Texas Drivers License. If applicant holds an out-of-state license, a State of Texas Driver License must be obtained within 6 months of employment.
Thorough background check and certified school transcripts will be required from all applicants who are offered employment.
Drug and alcohol test prior to employment.
Subject to random drug and alcohol testing for safety-sensitive functions/positions.
Must be able to function in a principle-based organization that has a culture built on character and core values.

Nice To Haves

Billing and Coding certification must be obtained within 12 months of employment

Responsibilities

Reviews, generates, and processes emergency ambulance transport medical claims
Determines appropriate CPT and ICD 10 codes based on the medical data and narrative furnished in ePCR (electronic Patient Care Report) and if additional medical information of ePCR is needed to bill accordingly
Serves as additional support staff to manage the numerous amount of medical claims that come from EMS related services
Retrieves hospital face sheets to obtain health insurance information and reviews and researches additional health insurance portals, if necessary
Determines primary, secondary, and/or tertiary insurances sequences based on insurance coverage per patient
Submits CMS1500 forms when necessary
Transmits electronic claims and reviews transmission reports for accepted and rejected claims
Responsible for reviewing claim batches to ensure it cleared the billing system and the clearinghouse's claim checks
Reviews medical and billing record requests in response to subpoenas, attorneys, hospitals, insurances, record retrieval companies and other companies or other organization requests
Prepare, invoice, and submit all medical and billing record and affidavit requests to respective parties
Provides customer service to patients in person and/or by telephone and is responsible for resolving reason for visit or call
Is responsible for taking payments, in person or over the phone
Reviews incoming correspondence and distributes accordingly
Assists in daily work assignments of lower complexity and any other clerical work assigned by program supervisor
Will be required to drive a City vehicle for City business use
Performs other duties as assigned