The primary job responsibility of the Billing Specialist is to ensure all completed transports are billed through the Client approved billing system accurately and compliantly to ensure timely reimbursement.
The Billing Specialist may be assigned one or more duties. These duties may include, but are not limited to, the following:
Interpret EPCR’s received by crews to bill according to the applicable laws set forth by the payor billed.
- Track all aspects of missing PCRs, PCSs and determines appropriate processing.
- Prepare “as needed” reports for management using PCR, PCS data.
- Monitor patient demographics of EPCR and relay information to the operations.
- Report findings of trends and developments from specific payors to management.
- Track and Analyze the Medical Necessity fields on EPCRs.
- Troubleshoot problem areas as identified on reports.
- Work with department manager to determine special projects on an as needed basis.
- Participate in documentation feedback information for the operations.
- Obtain continuous knowledge of CMS regulations.
- Make decisions and take appropriate actions based on sound reasoning and judgment.
- Contribute ideas; strive to enhance team effectiveness and support decisions made by the team.
- Plan and perform work systematically and efficiently.
- Carry out instructions, maintain a positive attitude, and support company policies/procedures.
- Punctuality and availability for workload.
- Comply with HIPAA guidelines
- Effectively work through denial/appeal process and meeting filing requirements
- Attend and maintain all required Falck USA training
- Maintain knowledge of functional area and company policies and procedures
The Billing Specialist may be assigned one or more additional duties. These duties may include, but are not limited to, the following:
- Assist with training new employees
- Providing feedback to management concerning possible problems or areas of improvement
- Making recommendations to implement improved processes.
- Performing other duties as assigned by management.