What are the responsibilities and job description for the Billing Specialist position at Pafford EMS?
Essential Duties and Responsibilities :
- Obtain referrals and pre / post-authorizations for ambulance services
- Check eligibility and benefits verification
- Review insurance and facility claims for accuracy and completeness
- Prepare, review, and transmit claims using billing software, clearinghouse, and payer websites
- Following up on unpaid claims within standard billing cycle timeframe
- Reviewing underpaid claims for appropriate escalation steps to ensure appropriate reimbursement for services
- Calling insurance companies regarding any payment discrepancies
- Identifying and billing secondary or tertiary insurance
- Processing incoming mail and taking appropriate follow up actions to resolve accounts
- Researching and appealing denied claims
- Answering all patient or insurance telephone inquiries
- Contacting the patient to escalate issues with the insurance companies
- Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Performing other duties as assigned.
Qualifications :
communicating with patients and family members of diverse ages and backgrounds.
Education and Experience Requirements :
Physical Requirements :
federal, state and local standards, including meeting qualitative and / or quantitative productivity standards.
standards.
depth perception, and the ability to adjust focus.
other physical exertion.
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.
