EMS Management & Consultants - Revenue Cycle Specialist

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All Jobs  >  Revenue Cycle Specialist EMS Management & Consultants Apply Revenue Cycle Specialist Fully Remote • Remote Worker - N/A Apply Description Job Summary The Revenue Cycle Specialist is responsible for reviewing and processing claims in various stages of the revenue cycle in a timely and compliant manner, in order to ensure highest reimbursement possible is achieved, as well as ensuring that all operational service commitments are met for assigned clients.  Major Responsibilities/Activities - Monitor overall client performance, identify potential loss or delay in revenue to ensure maximized reimbursement for assigned clients, seek and suggest solutions to maximize client performance. - Provide proactive, routine feedback and solutions, if needed, regarding client performance, workflows, processes, trends, industry changes, payer regulations, concerns, etc. to appropriate operational and management staff. - Initiate timely and proactive communication to payers to identify deficiencies and provide appropriate feedback to operational staff in order to resolve and prevent issues. - Prioritize, process, and delegate correspondence, rejections, denials, appeals, static claims, and all other follow up on claims in accordance with compliance standards and payer and client specifications; includes determining the next appropriate course of action for each claim. - Work independently to define problems, identify causes, and initiate steps necessary for resolution in a timely manner; follow through with the process to completion. - Regularly meet, and effectively communicate with, Supervisor Claims Management, onshore and/or offshore team members to ensure highest level of reimbursement is achieved through effective prioritization of work, and adherence to established standard operating procedures and vendor SLAs. - Holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though. - Monitor and measure client performance outcomes in comparison to client commitments; identify barriers, seek and suggest solutions when desired outcomes are not achieved. - Stay abreast of industry changes and regulations to ensure adherence and proactive preparedness. - Exhibit strong customer service skills to build and maintain internal and external relationships in order to best address client needs. - Consistently support and demonstrate the company mission and values. - Perform other duties as assigned.  Other Responsibilities/Activities - Remain informed and prepared to present client performance analysis as needed and directed by either the Senior Revenue Cycle Specialist, Supervisor, Claims Management, Revenue Cycle Manager or Operations Manager. - Serve as backup to other team members as required. - Perform other necessary tasks as assigned by either the Senior Revenue Cycle Specialist or Supervisor, Claims Management, Revenue Cycle Manager or Operations Manager. Requirements Required Education, Skills, & Experience - High School Diploma. - At least 1-2 years of experience processing health insurance claims and/or denials or other healthcare accounts receivable experience, or 1-2 years medical billing experience or at least 1 year EMS billing experience. - Ability to holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though. - Ability to organize, prioritize and multi-task. - Ability to learn, understand, and work within specific compliance, client, and payer requirements. - Approach all tasks, duties, and interactions with an attitude of continuous improvement. - Demonstrated understanding of applicable HIPAA regulations, Medicare, Medicaid, insurance, liability, and tertiary payment methods. - Willing and able to adapt to changes in work environment, procedures, priorities, and job duties. - Ability to function well within a cross-functional team setting and independently. - Strong critical thinking and analytical skills and attention to detail.  - Proficient in Microsoft Office programs. - Proficiency in English is necessary for job-related communication, including understanding policies, writing correspondence, and engaging with colleagues or clients. Preferred Education, Skills, & Experience - Strong preference for prior EMS billing and/or denials experience. - Proficient in EMS|MC billing software. Working Environment - The office environment is a controlled indoor setting with minimal exposure to adverse conditions.  - Noise levels in the office are typically moderate and consistent with a standard office setting.  - For employees approved to work in a hybrid or remote setting, a quiet, private workspace free from significant distractions is required to ensure productivity during work hours.  - A reliable internet connection is required for hybrid/remote work. EMS|MC will provide necessary equipment, including a computer, monitor, keyboard, mouse and headset.  Physical Requirements: - Sitting: frequent and prolonged periods of sitting at a desk while working on a computer.  - Communication: frequent and prolonged periods of speaking, listening, reading, and writing.  - Fine motor skills: frequent use of hands for typing and operating a computer mouse.   - Movement: occasional walking and climbing of stairs; limited bending, kneeling, lifting, and carrying of office-related items.    Pay range: $18.00 - $20.00 an hour, with final compensation based on the candidate’s qualifications, experience, and business needs. Individuals in this role are eligible to participate in a discretionary bonus plan and a comprehensive benefit package, including a retirement plan, health coverage, and paid time off. Visit https://emsmc.com/careers/ to explore our total rewards package.     Apply View All Jobs Powered by Privacy Policy Payroll & HR Software