Patient Insurance Specialist

EMS Management & Consultants, Inc.; Clemmons (NC); On-site; USD 22,000 - 26,000; Full time

Benefits offered by this job

Discretionary bonus

Health coverage

Paid time off

Retirement plan

Job summary

EMS Management & Consultants, Inc. is seeking a detail-oriented Hospital Billing Support specialist to maximize client reimbursement by accurately entering patient demographics and insurance information from EPIC and other hospital systems into EMS|MC billing software.

The role requires one year of healthcare office experience, a high school diploma, and the ability to learn new software quickly. You will verify patient insurance, update records, handle pending and rejected claims, and ensure

Qualifications

• High School Diploma or equivalent and at least 1 year in healthcare office or clinical setting.
• Strong data entry accuracy and ability to follow HIPAA and payer guidelines.
• Ability to learn new computer programs quickly and work with client requirements.

Responsibilities

• Enter data from EPIC or other hospital software into EMS|MC billing system with accuracy.
• Verify patient insurance by checking insurance websites to maximize reimbursement.
• Update patient demographics and insurance information across databases.
• Maintain compliance with patient matching standards.
• Provide feedback to Claims Management Supervisor on deficiencies and variances.
• Process pending and rejected claims timely and accurately.
• Deliver strong customer service and support client needs.
• Meet SLAs for turnaround times and compliance.
• Follow professional conduct and company policies.
• Support company mission and values.

Skills

Data entry

HIPAA compliance

Customer service

Time management

Attention to detail

Communication

Software learning

Education

High School Diploma

Tools

EMS|MC billing software

EPIC hospital database

Job description

Job Summary

Maximize client reimbursement through accurate and timely entry and processing of patient demographic information in accordance with client, company, and compliance standards. This includes searching multiple resources to obtain correct patient demographics and insurance in order to submit claims for reimbursement.

Major Responsibilities/Activities

• Using various defined resources along with sound judgment and critical thinking, enter direct data from EPIC and/or other hospital billing software into EMS|MC billing software ensuring adherence to client, company, and compliance standards.
• Check various insurance websites to discover and verify patient insurance maximizing reimbursement.
• Updating patient insurance and/or demographic information accurately from various databases.
• Ensure strict compliance with company standards regarding patient matching when adding patient information to avoid inaccurate updates.
• Provide proactive and routine feedback to Claims Management Supervisor regarding any deficiencies, variances, and/or other issues identified during the billing process, including variances with incoming inventory.
• Process all assigned pending and rejected claims in a timely and accurate manner.
• Exhibit strong customer service skills to build and maintain internal relationships in order to best address client needs.
• Meet or exceed contracted client service level agreements (SLAs) concerning turn-around-times and compliance standards on a consistent basis.
• Conduct all job tasks, 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.

Other Responsibilities/Activities

• Perform other necessary tasks as assigned.
• Working additional assignments for all hospital data as assigned.
• Involvement in special projects or meetings as directed.
• Provide backup assistance to other team Coding Specialist and Revenue Cycle Specialist as needed or when hospital data backlog is complete.
• Provide backup assistance to Customer Service department as needed or when hospital data is complete.

Performance Success Factors

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, and Average Cash per Trip.

Required Education, Skills, & Experience

• High School Diploma
• At least one-year experience in health care office, production, or clinical environment or comparable classroom experience
• Strong comfort level learning new computer programs and software at a rapid pace
• Self-motivated, goal oriented, and takes ownership of work
• Ability to learn, understand and work within specific client requirements
• Ability to learn, understand and apply applicable HIPAA, Medicare, Medicaid, insurance, and liability regulations/guidelines
• Willing and able to adapt to changes in work environment, procedures, priorities, and job duties
• Willing and able to receive positive and negative feedback and apply it to work environment in an appropriate and effective manner
• Strong internal customer service skills
• Good verbal and written communication skills
• Positive interpersonal skills with the ability to function well within a cross- functional team setting and independently
• Detail oriented with strong desire for accuracy
• Must be able to manage time and maintain focus, concentration, and productivity while performing repetitive and sometimes mundane work
• Strong, accurate data entry skills

Preferred Education, Skills, & Experience

• Prior EMS billing or EMS or healthcare revenue cycle experience
• Detailed knowledge of Medicare, Medicaid, Insurance, and patient claims
• Prior data entry experience
• Proficient in EMS|MC billing software
• Experience in working in Hospital data base such as EPIC

Working Environment/Physical Requirements

• General Office Environment
• Typing /entering data almost continuously
• Sitting for long period of time, some standing, some light lifting
• Use of basic office equipment such as fax, printer, copier, telephone

Pay

$16.00 - $19.00/hour

Benefits

Individuals in this role are eligible to participate in a discretionary bonus plan and a comprehensive benefit package, including a retirement plan, health coverage, and paid time off. Visit https://emsmc.com/careers/ to explore our total rewards package.

Accommodation and Work Authorization

Employees must be able to perform the essential functions of this position. Reasonable accommodations will be provided to qualified individuals with disabilities as needed to support their ability to perform these essential functions. If you require an accommodation for this position or to participate in the application process, please contact HR at [e-mail].

The responsibilities and duties outlined in this job description are not exhaustive and may be subject to change to meet the needs of the business. This job description is not an implied contract of employment and does not alter the at-will employment relationship.

There is no anticipated closing date for applications; The role will remain open until filled.

Applicants must be authorized to work in the United States now and in the future; this role does not offer current or future visa sponsorship.