Job Type

Full-time

Description

Who is EMS|MC

EMS|MC offers full-service revenue cycle management solutions and is the largest billing services provider focused exclusively on emergency medical services in the U.S. We offer services from software to hardware to billing services and everything in between.

For over 25 years, our high-quality service, results and customer-centric approach have set the standard in professional EMS billing. We have an emphasis on patient satisfaction and our client customization enables us to fulfill our mission of providing value-added, innovative financial services that enhance the delivery of a cost-effective EMS system.

With this level of specialization, we have built a team of dedicated, industry-leading experts with unprecedented experience to maximize our clients EMS revenue.

Why EMS|MC:

Career development plans and employee resource groups
Weekly wellness seminars
Comprehensive benefit package including medical, dental, vision and life insurance
Remote opportunities
All equipment provided

Job Type: Full-time

Location: Remote- USA

Title: Revenue Cycle Specialist

About the role:

Review and process 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.

As a Revenue Cycle Specialist with EMS|MC, you will:

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
Conduct all job tasks, calls, duties, and interactions with professionalism, respect, a positive attitude, and in accordance with company compliance policies and applicable government regulations
Consistently support and demonstrate the company mission and values.
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 teams 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

Performance Requirements

Maintain or exceed specified performance standards for each client, to include but not limited to Contracted Service Level Agreements, A/R Aging, Net Collection Percentages, Average Cash Per Trip, Denials, Rejections, Account Review Aging, and maintaining a 96% audit score monthly.

You will be successful in this role if you:

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
Detail-oriented
Resourceful
Self-starter
Must possess critical thinking/analytical skills
Proficient in Microsoft Office programs

Key skills we hope you have:

Strong preference for prior EMS billing and/or denials experience
Proficient in EMS|MC billing software

Working Environment/Physical Requirements

General office environment
Frequent typing
Sitting, standing, walking
Use of basic office equipment such as computer, fax, printer, copier, and telephone

Work at Home Requirements:

A quiet, distraction-free environment to work from in your home.
A secure home internet connection with minimum download speed of 20 Mbps for downloads a minimum speed of 10 Mbps for uploads is required.
The workspace area accommodates all workstation equipment and related materials and provides adequate surface area to be productive.

EMS|MC is an equal opportunity employer that does not discriminate based on race, color, religion, sex or gender, gender identity or expression, sexual orientation, national origin, age, disability status, veteran status, genetic information, or any other legally protected status.

We believe that a diverse workforce fosters innovation and creativity, enriches our culture, and enables us to better serve the needs of our clients and communities. We welcome and encourage individuals of all backgrounds, perspectives, and abilities to apply.

*Please note, our hiring process typically lasts 2-4 weeks with three to four interviews total.*

Salary Description

18.02

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