What are the responsibilities and job description for the Ambulance Coder/Claims Specialist (Remote) position at Pafford EMS?
Essential Duties and Responsibilities:
- Researches all information to complete accurate billing processes including assignment of billing charge codes and ICD-10 diagnosis codes
- Prioritize workflow to ensure timely claim submission
- Knowledge of state and federal insurance regulations
- Ability to analyze and problem solve complex issues
- Knowledge of billing requirements, coverage and benefits
- Uphold Medicare, Medicaid and HIPAA guidelines
- Identifies and communicates documentation issue trends
- Utilize various resources to locate insurance payers for ambulance transportation
- Contact the hospital, patient’s family, and/or patient to obtain insurance information
- Fax partner hospitals requests for information
- Validate and update patient demographics in the practice management system
- Responsible for the accurate entry of data into the practice management system
- This position requires specialist to spend extended periods of time on the phone with insurance companies
- Reports quality and documentation issues to the department head
Qualifications:
- Knowledge of procedure and diagnostic codes (HCPCS and ICD-10 codes)
- Knowledge of medical terminology
- Researches all information to complete accurate billing processes including assignment of billing charge codes and ICD-10 diagnosis codes
- Prioritize workflow to ensure timely claim submission
- Knowledge of state and federal insurance regulations
- Ability to analyze and problem solve complex issues
- Knowledge of billing requirements, coverage and benefits
- Uphold Medicare, Medicaid and HIPAA guidelines
- Identifies and communicates documentation issue trends
- Reports quality and documentation issues to the department head
- Knowledge of Medical Billing
- Ability to work independently and with a group
- Working knowledge of MS Word, Excel
- Ability to maintain effective working relationships.
- Ability to type at least 35 words per minute.
- Proficiency using 10 key
Education and Experience Requirements:
- High School Diploma or GED
- Minimum of one year revenue cycle management experience preferred
Other Requirements:
- Must have access to high-speed internet
- Position is remote, but must be within 100 miles of OKC or Tulsa Oklahoma
Physical Requirements:
- Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
- Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.
- The employee may occasionally be required to lift and/or move up to 20 pounds
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
- Work may require sitting, lifting, stooping, bending, stretching, walking, standing, pushing, pulling, reaching, and other physical exertion.
- Must be able to talk, listen and speak clearly on telephone.
- Must possess visual acuity to prepare and analyze data and figures, operate a computer terminal, and operate a motor vehicle.
Travel Time: Negligible
NOTE: The above statements are intended to describe the general nature and level of work being performed by the person assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, skills and physical demands required of personnel so classified.
