What are the responsibilities and job description for the Medical Billing Specialist position at LifeLine Ambulance, LLC?
DESCRIPTION: Preforms a wide range of ambulance billing duties including preparation of ambulance claims, interaction with numerous insurance companies/payers including but not limited to CMS Medicare, Medicaid, SC Medicaid broker, private insurances and contract facilities. To perform aging/follow up of claims as well as collections on outstanding claims. Serve as a point of contact for LifeLine Ambulance and other contracted providers’ clients regarding the financial components of the ambulance transport. As well as any other duties that may deemed necessary as the company continues to grow.
GOAL: To generate revenue for all contracted providers by processing and submitting “clean” claims to insurances companies
DUTIES:
1) Receives and reviews PCR from TraumaSoft to validate medical necessity based on information provided and carrier specifications. Checks the PCR to make sure it is complete with proper signatures and valid forms.
2) Ensures that work is carried out in compliance with all policy and regulatory requirements.
3) Determine defined payer requirements to facilitate claim acceptance and assign appropriate charge codes and modifiers. Provide additional required documentation including certification of medical necessity information, schedules and other items as required for processing.
4) Accurately receives and posts a variety of financial information to accounts and maintains appropriate records.
5) Responds to questions regarding medical necessity under Medicare and assists patients by providing information regarding the filing of appeals.
6) Generates requests for refund checks for any overpayments, assuring funds are sent to the correct parties and/or agencies.
7) Responsible for tracking non-signature or incomplete PCS. Generate and mail letters requesting signatures and document all attempts to get a PCS.
8) Transmits claims electronically and verify confirmation of receipt.
9) Submits all paper claims to appropriate insurance companies, assuring all documentation is attached as required by the carrier.
10) Answers telephone calls, resolves patient inquiries, issue statements, insurance bills, and medical records as required within specific operating guidelines.
11) Responds to complaints and questions related to accounts payable: provides information, researches problems and initiates problem resolutions.
12) Sorts, organizes, opens and/or distributes incoming mail including making bank deposits of paper checks; prepares outgoing mail and sends to post office.
13) Runs aging reports for outstanding accounts and works aging to assure proper payment is received.
14) Performs any other duties as requested or assigned.
15) Prepares and assists with collections of outstanding accounts.
QUALIFICATIONS:
· High School Diploma or equivalent,
· Certified Ambulance Coding Certificate a plus but not required.
Job Types: Full-time, Part-time
Pay: $15.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
Work Location: In person
Salary : $15
