About the role
- Perform post-billing review for eligible/valid patient or other applicable signatures to release claims for payment
- Conduct post-billing review for third-party liability coverage
- Review hospice-related claims to determine the appropriate payor
- Review insurance information captured after initial billing to determine the correct payor
- Submit new and corrected claims through online payor portals
- Perform quality assurance reviews of claims processed by other segments
- Attend and actively participate in team huddles and other required meetings
- Consistently meet or exceed production goals while maintaining high-quality work
- Provide timely feedback to leadership based on tasks worked
- Maintain a high level of compliance with all regulatory requirements and internal policies and procedures
Requirements
- High School Diploma required
- 3+ years EMS Billing preferred
- Certified Ambulance Coder (CAC) preferred
- QMC Biller Certification preferred
- Highly detailed-oriented
- Proficient in Excel functions such as filters, pivot tables, and conditional formatting
- Strong working knowledge of EMS billing rules and regulations
- Clear understanding of health insurance payor groups (Medicare, Medicaid, Commercial)
- Ability to identify problems and escalate issues appropriately to leadership
- Ability to quickly adapt to, learn, and retain changing client, payor, state, and MAC region rules and specifications
- Quality-focused and process-driven
- Excellent problem-solving skills
- QMC HIPAA privacy policies and procedures adherence
- Maintaining confidentiality and security of sensitive patient information
- Consistent adherence to company attendance policies
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
EMS BillingExcel functionsfilterspivot tablesconditional formattingclaims processingquality assurancepost-billing reviewclaims submissionregulatory compliance
Soft skills
detail-orientedproblem-solvingadaptabilitycommunicationteam participationfeedback provisionquality-focusedprocess-drivenissue escalationproduction goal achievement
Certifications
High School DiplomaCertified Ambulance Coder (CAC)QMC Biller Certification