Prebill Specialist I - Remote Billing Verification & QC

sarnova; United States; Remote; USD 40,000 - 55,000; Full time

Benefits offered by this job

401(k) Plan

Job summary

Sarnova is seeking a Prebill Specialist I to verify prebill information in the RCM process, ensuring patient demographics, payor details, and transport modifiers are correctly entered before coding. The role emphasizes accuracy, efficiency, and adherence to privacy standards to support our commitment to client trust and quality.

In this remote position, you will use hospital systems to locate data, enter demographics, and follow billing guidelines.

Qualifications

• 1+ year of revenue cycle management experience preferred
• Ability to identify problems and escalate issues appropriately to Prebill Lead
• Motivated self-starter, independent thinker capable of working both independently and within a collaborative team environment
• RCM experience preferred
• Working knowledge of health insurance verification and basic understanding of major payor groups (Medicare, Medicaid, Commercial), preferred
• Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment

Responsibilities

• Utilize preferred system tools (hospital registration system, face sheet, HL7 feed, etc.) to locate insurance and patient demographic information
• Place claims in the Insurance Discovery workflow when no insurance is found
• Accurately enter patient demographics
• Follow the Master Billing Guide instructions to select the appropriate modifiers and payors for the transport
• Follow the SOPs to select the appropriate modifiers, tags, and payors
• If required, call facility payor (SNF, Assisted Living, Hospice) to confirm appropriate transport modifiers
• Participate in Prebill Huddles to review and align on processes
• Upon verifying patient, payor, and modifier information, place the claim in the appropriate tag for the next step
• Consistently achieve or exceed the Prebill Specialist’s daily production and quality goals
• Adhere to all Digitech HIPAA privacy policies and procedures. This includes always maintaining the confidentiality and security of sensitive patient information
• Additional job duties as assigned

Skills

Revenue Cycle Management

HIPAA privacy

Problem identification

Independent work

Remote work adaptability

Payor knowledge

Attention to detail

Education

High School Diploma or equivalent

Tools

Hospital registration system

HL7 feed

Job description

Sarnova is seeking a Prebill Specialist I to verify prebill information in the RCM process, ensuring patient demographics, payor details, and transport modifiers are correctly entered before coding. The role emphasizes accuracy, efficiency, and adherence to privacy standards to support our commitment to client trust and quality.

In this remote position, you will use hospital systems to locate data, enter demographics, and follow billing guidelines.