• •Manage claims over 90-days on the A/R reports in a timely manner
• Attach no-pays to the correct account
• Review non-financial correspondence and route to the appropriate departments for processing
• Manage hospital requests for ER notes and discharge summaries to support billing processes
• Sort, scan, and attach non-financial mail and documentation to the appropriate accounts
• Perform data entry and account updates, including patient and insurance information
• Assist with gathering supporting documentation for appeals and claims processing
• Provide general administrative support as needed
• Follow all state and federal collections and HIPAA laws
• Align with & support Emergicon’s core values & behaviors
• Other job-related duties as assigned

• Ability to communicate effectively and in a professional manner with patients, insurance carriers, co-workers, management and others
• General knowledge of ambulance medical billing/coding process
• Ability to prioritize and multi-task
• Basic proficiency in computer applications, including email, word processing, and spreadsheets
• Must possess strong attention to detail
• Ability to establish/maintain cooperative working relationships with staff
• Strong verbal and written communication skills

• HS Diploma/GED required
• Experience in Medicare A/R, appeals, correspondence and denials a plus
• At least one (1) year of experience in medical billing, accounts receivable, healthcare administration, or a related field preferred

REPORTS TO

This position reports directly to the Patient Accounts Manager and works collaboratively with other Emergicon personnel across all departments.

ESSENTIAL DUTIES AND RESPONSIBILITIES

·        Handle high-volume inbound calls related to claims and statement inquiries from patients, insurance companies, and law offices.

·        Make outbound calls to resolve delinquent accounts through patient payment arrangements.

·        Process credit card and ACH transactions efficiently and accurately.

·        Ensure compliance with state and federal collections regulations, as well as HIPAA requirements.

·        Other job-related duties as assigned.

EDUCATION AND EXPERIENCE

·        High School Diploma or equivalent (GED) required

·        Bilingual in English and Spanish a plus

·        At least six months of experience in customer service, collections, healthcare billing, or patient accounts required.

KNOWLEDGE, SKILLS, AND ABILITIES

·        Strong oral and written communication skills to interact effectively with customers and all levels of management

·        Proven ability to prioritize tasks, solve problems, and manage multiple responsibilities simultaneously

·        Strong interpersonal skills with the ability to collaborate effectively in a team environment

·        Proficient in general computer skills, including word processing, spreadsheets, and email applications

·        Knowledge of HIPAA compliance regulations and ability to handle sensitive patient information appropriately

WORKING CONDITIONS

Position requires long periods of sitting/standing at a desk while using a computer.

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     *Not only are we the largest EMS Billing Company in Texas, but we are also the BEST at what we do!! COME GROW WITH US!!

     *We offer hands on Training & Development-Cross Training & Growth within our EMERGITASTIC Company!

PRIMARY FUNCTIONS:

The Accounts Receivable Specialist is responsible for reviewing claims to ensure maximum reimbursement by following up with insurance carriers and patients as well as recognizing any trends in reporting and communicating those trends to the lead and/or manager for review.

REPORTS TO/SUPERVISES:

The Accounts Receivable Specialist reports directly to the Accounts Receivable Manager. This position works collaboratively with other Emergicon personnel in all departments.

ESSENTIAL DUTIES and RESPONSIBILITIES:

• Manage all claims over 60-days on the A/R reports in a timely manner
• Work assigned denials and correspondence 
• Utilize clearinghouse and insurance portals for claim status
• Report all trends detected in A/R management
• Prepare corrected claims and appeals, as needed
• Process inbound and outbound calls as needed to insurance carriers
• Follow all state and federal collections and HIPAA laws
• Align with & support EMERGICON’ S core values & behaviors
• •Other duties as assigned
• 
  

REQUIRED KNOWLEDGE AND EXPERIENCE:

• Maintain any certification applicable to job functions
• Computer Literacy
• Ability to communicate effectively and in a professional manner with patients, insurance carriers, co-workers, management, and others 
• Detail Oriented 
• Knowledge of managed care plans, insurance, medical terminology
• Knowledge of reimbursement fee schedules (Medicare and Medicaid)
• Knowledge of refund processes and requirements
• Ability to establish/maintain cooperative working relationships with staff
• Ability to prioritize and multi-task

PREFERRED KNOWLEDGE AND EXPERIENCE

Experience in Medicare A/R, Commercial insurances, appeals, correspondence, and denials is a plus.

ESSENTIAL DUTIES AND RESPONSIBILITIES

•  Meet individual production targets for claims processing while maintaining accuracy and compliance.

•  Retrieve and review incident data from clients to ensure all necessary information is collected.

• Communicate effectively with insurance adjusters, insured drivers, and businesses to clarify information and facilitate claim processing.

•  Verify the accuracy and completeness of submitted claims prior to submission.

•  Enter, update, and maintain insurance policy and claim information in the company database.

•  Calculate, prepare, and submit accurate billing to insurance carriers promptly.

•  Process inspection and claim payments, including over-the-phone payments.

•  Monitor claim statuses and follow up on unpaid or delayed claims to ensure timely resolution.

•  Manage appeals and respond to denied claims as needed, providing supporting documentation.

•  Contact responsible parties and insurance companies regarding claims outstanding over 30 days.

•  Maintain accurate and organized records for all assigned accounts.

•  Assist with special projects and perform other duties as assigned.

EDUCATION AND EXPERIENCE

•  High school diploma or equivalent required; associate degree in insurance, business administration, accounting, or a related field preferred.

•  Minimum of one year of experience in fire incident claims processing or a related field required.

•  Familiarity with fire terminology and report structure required.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

•  Intermediate or higher proficiency in Microsoft Office (Excel, Outlook, Word).

•  Strong customer service skills and professional demeanor.

•  Excellent verbal and written communication skills.

•  High level of accuracy and attention to detail.

•  Ability to manage multiple priorities and meet deadlines in a fast-paced environment.

•  Strong organizational and time management skills.

Emergicon requires satisfactory pre-employment background check and drug screen.