Senior Medicare & Medicaid Biller/ Collector at Empress Ambulance Services in Poughkeepsie, New York

Job Description:

Empress Ambulance Services

Location: Poughkeepsie, NY

Department: Billing
FLSA Status: Exempt


Summary

Responsible for knowing, understanding, and following Insurance billing regulations for Non-Emergency and Emergency Ambulance billing. Running and providing department reports for monitoring purposes. Completing and maintaining projects assigned for Medicare/Medicaid.

Key Responsibilities

• Responsible for ALL aspects of Billing and Collections for 911 and Non-Emergency Ambulance Service Provider such as Medicare, Medicaid, insurance denials.

• Liaison between senior management, employees, and clients to ensure proper lines of communication critical in addressing a myriad of problems and issues requiring immediate attention and resolve.

• Provide general administrative and clerical support including but not limited to receiving, maintaining medical records, faxing, copying & scanning.

• Responsible for training and coaching team members on new and/or existing procedures.

• Responsible for daily/ weekly & monthly reporting of following reports & Medicare application compliance items.

• Attending industry Webinars/ Conferences and preparing summary to ensure we are up to date with industry & billing compliance standards.

• Responsible for reviewing PCS forms to expedite claim submission & collections.

• Submitting RR Medicare record requests.

• Work closely with Department Managers/ Supervisors to create improvement & implement processes to ensure department goals and objectives are met on in a consistent basis.

• Submitting Medicare appeal via Medicare online portal to expedite payment.

• Review weekly CDI lists to ensure accounts are updated timely in effort to expedite claim submission & payment.

• Work on Medicare/ Medicaid denials to Identify trends & expedite claims processing & payment.

• Responsible for completing department projects as assigned that will assist in trend analysis, compliance & revenue improvement.

POSITION QUALIFICATIONS

Education & Experience

• High School Diploma, Associate degree preferred.
• Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC) preferred.
• Extensive Medicare and Medicaid experience and understanding medical necessity in ambulance transportation.
• Ambulance/Medical billing certification or diploma preferred.
• Maintain working knowledge of ICD-10, CPT and HCPCS coding, NPI, HIPAA, Modifiers, EPCR's and all forms of medical billing (direct, 3rd party, HMO's, private pay, no-fault, worker's comp, Medicare & Medicaid
• Excellent organizational skills and the ability to multi-task in a fast-paced environment
• Review and research data; use intuition and experience to complement data.
• Thorough knowledge of transport documentation (PCRs)
• Ability to follow up on outstanding Medicare accounts.
• Ability able to submit appeals and overpayment requests.
• Familiar with Medicare/CMS requirements and guidelines.
• Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance.
• Excellent written and verbal communications skills required • Excellent documentation skills (promptness, accuracy, thoroughness, and legibility).

• PCS/ Medical necessity.

• Customer Service/ Client relations.

Competencies

• Working knowledge of EMS systems/private ambulance and medical transportation systems preferred.
• Knowledge of CONNEX preferred.
• Knowledge Microsoft Word, Microsoft Excel, and Microsoft Windows.
• Familiarity with medical terminology
• Organizational and leadership abilities, detail oriented.

Work Environment

• Work is performed under normal working conditions, as in a standard office environment.

Physical Requirements

• High level of sitting/working at a desk
• Light physical effort (lift/carry up to 10 lbs.)
• Must be able to perform the essential duties of the position with or without reasonable accommodations.

All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or other legally protected status.

PI249832556

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