Job Description
Job Title: Pre-Billing Specialist
Reports to: Director of Revenue Cycle Management
Through: Billing Operations Manager
Department: Revenue Cycle Management
Location: Remote or in-house
FLSA Status: Non- Exempt
POSITION SUMMARY:
The fundamental responsibilities of the Pre-Billing Specialist are to review ambulance transport documentation and verifying billing information prior to claim submission. This role ensures accuracy in patient demographics, insurance coverage, and coding to reduce claim denials and expedite reimbursement. The Pre- Billing Specialist will work closely with field personnel, dispatchers, operations, and other billing staff to resolve discrepancies, obtain missing information, and confirm compliance with payer requirements
Essential Duties and Responsibilities:
Pre-Billing inclusive of but not limited to Charts, Insurance Verification, and Coding.
Communicate with customers in a professional manner.
Interact with payers to secure timely payment.
Verify payer coverage through resources available.
Maintain knowledge of payer regulations, timely filing deadlines, payment and appeals policies and procedures.
Represent the organization professionally and appropriately.
Answer inbound calls daily from customers, vendors, as well as other calls.
Communicate with all facilities, Brewster employees and vendors in a professional manner.
Ability to work in and participate in a team environment while performing at the highest standards independently.
Non-Essential Duties and Responsibilities
Perform other duties as assigned.
Physical Requirements- (Field Employees Only)
N/A
Minimum Qualifications:
(Preferred) Two (2) years’ experience in ambulance medical billing.
Able to work independently.
(Preferred) Comprehensive understanding of federal reimbursement guidelines.
High level computer skills.
Excellent interpersonal skills.
Service oriented.
Education/Licensing/Certification:
(Preferred) Be a currently state certified EMT, EMT-A, or Paramedic.
(Preferred) Be CAC certified.
High school diploma.
Current state driver’s license.
Other Knowledge and Skills:
Maintains professional competence and demonstrates concern for the competence of other members of the EMS health care team.
Maintain HIPPA Compliance.
Strong ability to multi-task at a high pace environment.
Ability to uphold standards of practice and education.
Ability to adhere to standards of personal ethics, on and off duty, which reflect credit upon the profession.
Does not use professional knowledge and skills in any enterprise detrimental to the Company or to the public well-being.
Ability to respect and hold in confidence all information of a confidential nature obtained in the course of professional work unless required by law to divulge such information.
Has good working knowledge of all company policies pertaining to this position.
Good knowledge of common physical illnesses, obvious symptoms, and medical terminology.
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