Overview:
EMS Revenue Specialist
The EMS Revenue Specialist is responsible for working directly with the Health Insurance Companies to resolve open balances. This could include but not limited: utilizing payer portals to check claim status, updating patients’ insurance policy, reviewing / updating the ICD-10 code listed, sending corrected claims and/or appeals.
All representatives will conduct insurance verification as needed and are required to complete prebilling training to qualify for the role.
Responsibilities:

Responsibilities of the EMS Revenue Specialist

• Places and receives calls regarding billing insurance questions and other patient service activities.
• Process accounts according to the action required to resolve account balances.
• Resolving insurance carrier denials, appealing claims, contacting carriers on open accounts, and responding to insurance carrier correspondence and/or inquiries.
• Comfortable communicating with any caller including customers, agencies, facilities, and hospitals.
• Employ one-step resolution practices for clients and patients through open lines of communication.
• Research patient accounts to verify all health insurance coverages. Audit patient accounts to verify proper billing process was followed.
• Compute adjustments based on EOB’s remittance and insurance contracts.
• Ensure accuracy in data entry and consistent attention to detail.
• Collect outstanding balances as well as identify, address, and resolve account discrepancies while following company policy and procedures.
• Demonstrates knowledge and compliance of insurance, local, state, and federal billing.
• Ability to complete tasks efficiently both individually and in a group environment.
• Handle assigned correspondence fulfilling any other duties as assigned by managerial staff.

Key Skills of the EMS Revenue Specialist

• Well-versed with medical billing practices that include an understanding of insurance billing codes, regulations, and procedures.
• Ability to investigate and resolve software issues, billing errors and disputes.
• Effective communication skills with clients, insurance companies, patients, staff members and management.
• Ability to manage multiple tasks and meet deadlines.
• Must have great attention to detail with high accuracy.

Qualifications:

Qualifications of the EMS Revenue Specialist

• College preferred but not required.
• Minimum two years’ experience in customer care, account management or similar role.
• Ability to read and understand the Explanation of Benefits or Electronic Remittance Advice.
• Understands the difference between rejections and denials as well as working accounts.
• Healthcare knowledge is preferred.
• Must be a quick learner and motivated individual with excellent verbal communications skills.
• Ability to “multi-task” and manage spurs of high call volume / stress.
• Positive, can-do attitude and with good judgement demonstrating ability to escalate account when needed.
• Ability to receive and implement feedback.

Computer and Office Qualifications of the EMS Revenue Specialist

• Computer literacy is a must; Typing skillset of at least 45 WPM is highly desired
• Experience working in an active office environment.
• Must be able to work with 2 monitors and split screens to operate multiple sites simultaneously.
• Must be able to sit / stand for 8 hours minimum in an office environment
• Must be able to use Word, Excel Spreadsheet, Email, Chat Applications, and other software applications.
• Must be able to read, comprehend, and apply job-related rules, policies, and procedures.

Salary or Wage Range: USD $20.00 - USD $23.00 /Hr. rates offered based on years of experienc

• Places and receives calls regarding billing insurance questions and other patient service activities.
• Process accounts according to the action required to resolve account balances.
• Resolving insurance carrier denials, appealing claims, contacting carriers on open accounts, and responding to insurance carrier correspondence and/or inquiries.
• Comfortable communicating with any caller including customers, agencies, facilities, and hospitals.
• Employ one-step resolution practices for clients and patients through open lines of communication.
• Research patient accounts to verify all health insurance coverages. Audit patient accounts to verify proper billing process was followed.
• Compute adjustments based on EOB’s remittance and insurance contracts.
• Ensure accuracy in data entry and consistent attention to detail.
• Collect outstanding balances as well as identify, address, and resolve account discrepancies while following company policy and procedures.
• Demonstrates knowledge and compliance of insurance, local, state, and federal billing.
• Ability to complete tasks efficiently both individually and in a group environment.
• Handle assigned correspondence fulfilling any other duties as assigned by managerial staff