Medical Billing and Coding Specialist II
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Job Description
Medical billing specialist coding EMS claims for Digitech, a provider of outsourced billing and business-intelligence services for EMS transport. Reviewing claims, ensuring compliance, and meeting accuracy targets.
Responsibilities:
- Utilize Master Billing Guides and other process instructions to review PCR for medical necessity, reasonableness, appropriate modifiers, level of service, ICD10 code and mileage
- Complete the Billing quality scrub process
- Review PCS for validity, if required
- Review Medicare AOB, if required
- Place claims on the appropriate tag when additional information is needed
- Attend and actively participate in daily Billing team huddles
- Consistently achieve Billing Specialist II performance and quality metrics
- Provide accurate billing in compliance with regulatory requirements and internal policies and procedures
- Demonstrate biller competency by achieving and maintaining billing accuracy scores meeting or exceeding expectations during quality assurance and audit activities
- Adhere to Digitech HIPAA privacy policies and procedures, maintaining confidentiality and security of sensitive patient information
- Perform additional job duties as assigned
Requirements:
- High School Diploma or equivalent
- 2+ years EMS Billing preferred
- Certified Ambulance Coder (CAC) preferred
- Demonstrated ability or willingness to attain QMC Biller Certification upon employment
- Very detailed-oriented
- Strong, working knowledge of EMS billing rules and regulations
- Understanding of health insurance payor groups (Medicare, Medicaid, Commercial)
- Ability to identify problems and escalate issues appropriately to a Billing Lead
- Ability to quickly adapt, learn and retain changing rules and specifications by clients, payors, states and MAC regions
- Quality-focused and driven by process
- EMS billing platform knowledge preferred
- Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment
Benefits:
- Competitive salary, commensurate with experience
- Comprehensive benefits package
- 401(k) Plan
- Remote work environment
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