Ambulance Revenue Cycle and Appeals Specialis

GENERAL SUMMARY (THE VALUE YOU WILL ADD TO OUR TEAM):

Acute Rescue is looking to hire an Ambulance Revenue Cycle and Appeals Specialists with a head for figures and a heart for helping others. Everyone on our administrative team has a role to play in providing great customer service for a broad cross-section of clients, so you will get to use your excellent communication and interpersonal skills, as well as accuracy in this demanding role. After your probationary period, you may qualify for our robust Benefits package. Best of all, you'll have the chance to leave every day knowing you've helped others as part of a caring staff. This role manages the ambulance billing cycle from post-claim submission through payment collection, requiring a thorough understanding of ambulance billing, insurance claims, insurance appeal processes, and compliance regulations, including familiarity with Idaho State rules and regulations regarding the Idaho Patient Act.

ESSENTIAL FUNCTIONS:

• Handle collections on past-due accounts by making outbound calls to patients and insurance companies to secure payment.
• Resubmit denied claims to insurance companies with appropriate appeals, corrections, or documentation, and follow up on outstanding claims.
• Review and resolve claim rejections, denials, and appeals in a timely manner.
• Adjudicate claims, ensuring they meet payer requirements, and file appeals when necessary to obtain payment, including communicating with insurance providers, hospitals, and patients to clarify and resolve billing issues or missing information.
• Identify claims rejected due to provider credentialing issues and coordinate with Administration to resolve outstanding credentialing needs and support timely claim resubmission.
• Apply late fees and other processing fees to overdue accounts according to company policy and legal guidelines.
• Process payments for patients and make appropriate notations in patient and claim accounts.
• Set up and manage patient payment plans to facilitate manageable payments and reduce outstanding balances.
• Exhaust all internal collections efforts prior to submitting delinquent accounts to collection agencies.
• Maintain up-to-date knowledge of billing regulations, codes, and standards specific to ambulance services, including Medicare and Medicaid.
• Ensure proper documentation and coding of all ambulance services rendered.
• Collaborate with internal teams to gather necessary information for accurate billing.
• Prepare and send patient statements and handle inquiries regarding delinquent bills.
• Monitor accounts receivable and take necessary actions to collect overdue payments.
• Generate regular reports on billing and collection activities for management review.
• If working remotely, participate in weekly virtual meetings to discuss challenges, account status, and progress updates.

QUALIFICATIONS:

• High school diploma or equivalent.
• Minimum of 5 years of experience specifically in ambulance billing. General medical billing experience does not satisfy this requirement.
• Ambulance Billing and Coding Specialist certification preferred.
• Experience with Logis billing is a plus.
• Strong knowledge of ambulance billing procedures, commercial and supplemental insurance plans, and healthcare regulations, including Medicare and Medicaid.
• Proficiency in using billing software and electronic medical records (EMR) systems.
• Excellent analytical and problem-solving skills.
• Strong attention to detail and accuracy.
• Effective communication and interpersonal skills.
• Ability to manage time effectively and work independently.
• Compassionate and empathetic communication skills.
• If working remotely, must maintain a HIPAA-compliant secure network and internet connection.

OTHER INFORMATION:

Local, in-person position preferred.

Position could be remote for the right candidate.

ART MISSION AND VISION STATEMENTS, AND CORE VALUES:

Mission Statement:

To deliver exceptional medical care and transportation with a steadfast dedication to unparalleled customer service. We embrace open communication, respect, and a genuine commitment to the needs of those both within our organization and in the communities we serve. We strive to exceed expectations by listening attentively, responding with empathy, providing innovative solutions, and consistently delivering service that reflects our commitment to excellence. We believe fostering strong partnerships with healthcare collaborators creates a healthier and more connected community, where providing humanitarian-based medical care and exceptional customer service go hand-in-hand.

Vision Statement:

We aspire to redefine the industry standard by introducing cutting-edge technologies, investing in people, and a humanitarian-based approach that prioritizes customer service, patient outcomes and the personal development of individuals. By challenging traditional paradigms and embracing progressive methodologies, we aim to set a benchmark for excellence in EMS. Through our visionary leadership and relentless commitment to improvement, we envision transforming the way emergency medical services are delivered, ensuring swift, precise, and compassionate care for every individual in need.

CORE VALUES

“Collaboration”

We believe in the power of collaboration, where individuals unite their strengths to achieve common goals. By fostering a culture of open communication, adaptability, and trust, we can address challenges constructively, using them as opportunities for growth and innovation. We remain flexible and receptive, understanding that collaboration often requires adjustments and innovative problem-solving for continued success.

“Investment”

At the heart of our healthcare mission is an unwavering commitment to investing in people. Recognizing the profound impact of personal growth, we actively nurture our team's potential, fostering a culture of continuous learning and professional development. By empowering individuals, cultivating their skills, and prioritizing their well-being, we create a resilient, compassionate workforce. By committing resources, time, and engaging with community members and organizations, we aim for sustainable positive impacts to the communities we serve. We believe that an investment in people is an investment in a better world.

“Integrity”

Acute Rescue believes in acting with honor regardless of whether our actions are public or private. We are committed to the words we speak. We uphold unwavering honesty, transparency, accountability, fairness, and ethical conduct in all endeavors. Placing a strong emphasis on integrity prioritizes truthfulness in communication, ethical decision-making, and honoring commitments.

DISCLAIMER:

To perform this job successfully, an individual must be able to perform the essential functions satisfactorily with or without reasonable accommodation. The above statements are intended to describe the general nature and level of work being assigned to this job. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of individuals in the job. This job description is not an employment agreement and/or an expressed or implied employment contract. Management has the exclusive right to alter this job description at any time without notice.