Billing Resolution Specialist I
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PA
Company:
Quick Med Claims is a nationally recognized leader in emergency medical transportation billing and reimbursement.
Summary:
The Billing Resolution Specialist I resolves issues that prevent claims from being processed correctly. Candidates should have a high school diploma and preferably 3+ years of EMS billing experience.
Requirements:
Hard Skills: Detail-oriented, Strong knowledge of EMS billing rules and regulations, Ability to identify problems and escalate issues, Ability to adapt to changing rules and specifications, Quality-focused, Excellent problem-solving skills, RescueNet or Tritech billing platform knowledge
Credentials: High School Diploma, Certified Ambulance Coder (CAC), QMC F10 Certified
Experience: 3+ years EMS Billing preferred
Job Description:
Quick Med Claims (QMC) is a nationally recognized leader in emergency medical transportation billing and reimbursement. QMC is committed to providing services in a manner that ensures compliance with all applicable billing and reimbursement regulations while maximizing the capture of allowable reimbursement for each client. The commitment to adherence to both principles make QMC the partner of choice for emergency medical transportation providers.
The Billing Resolution Specialist (BRSI) plays an important and fundamental role in QMC’s RCM process by ensuring claims are coded and billed accurately and timely. The BRSI must maintain a strong working knowledge of billing rules and regulations for all payor types in the various regions for which they process claims. The BRSI must be detailed oriented and driven by the highest quality standards. The BRSI is focused primary on resolving any issue that keeps a claim from being released to the appropriate payor.
This position is 100% work from home.
Maintaining the highest quality billing standards is critical to QMC achieving its overall quality goals and vision to be the trusted partner of choice that 100% of our clients would recommend to a friend or colleague.
Responsibilities:
- Reviews and manages the following workflows:
- Deductible Management
- Bad Addresses (various systems – billing platform and ImageSilo)
- SNF Calls for Part A check
- Patient Services
- Insurance Captured
- PCS (and SendPro requests)
- ZDBatch Failures
- AOBs (via eServices & ImageSilo)
- Biller Attention Needed
- ACE Exception Portal
- Membership Checks after Insurance Pays
- In addition, for Danville, the below will also be review and manage:
- ALS Reports Folder
- ALS Release Schedule
- JBA (Joint Billing Agreement) Manual Review
- Attach DocStar documents to RescueNet for processing
- Monitors and processes incoming fax que (Ring Central)
- Manually enters claims directly to payors when required by Medicaid and other secondary payors
- Completes Authorization requests when required
- Attends and actively participates in daily Billing team huddles
- Consistently achieves Billing Resolution daily performance and quality metrics
Other Responsibilities:
- Adhere to all QMC HIPAA privacy policies and procedures. This includes always maintaining the confidentiality and security of sensitive patient information.
- Ensures consistent adherence to company attendance policies.
