Revenue Cycle Specialist - Appeals

Rural Metro Fire Department; Northern (KY); Hybrid; USD 28,000 - 30,000; Full time

Job summary

AMR is seeking a Revenue Cycle Specialist – Appeals to manage Medicare billing and follow-up from a remote location in the United States. You will prepare billings, respond to inquiries, and handle all appeal-related correspondence.

You will review denials, balance journals, and ensure compliance with government guidelines and company policies, while maintaining a 95% QA accuracy. Strong typing and MS Office skills are required.

Qualifications

• Minimum of one year office work experience
• Minimum of one year medical billing experience
• Experience with ambulance coding and appeals is highly preferred
• Knowledge of HCPCS is preferred
• Prior Medicare billing/follow-up experience preferred
• Experience with Medicare, Medicaid, HMO, PPO appeals preferred
• General PC knowledge required
• Experience with website navigation required
• Must type 45 wpm and use ten-key calculator by touch
• Experience with ICD-9 and ICD-10 coding is required
• Ability to work under tight time constraints and handle large volumes
• Team-oriented work ethic

Responsibilities

• Prepare and submit all billings expeditiously
• Respond to Medicare inquiries by phone and mail
• Follow up on all appeals and fair hearings
• Process denials to maximize benefit
• Adhere to company policies and procedures
• Ensure customer problems are handled promptly
• Process and review assigned queues daily
• Monitor Medicare regulation changes and inform supervisor
• Input claim data daily
• Balance journals periodically
• Ensure compliance with government and corporate guidelines
• Pass QA audits with 95%+ accuracy

Skills

Medicare billing

Typing 45 wpm

Team collaboration

Deadline management

Medical terminology

Education

High school diploma or GED

College coursework in psychology/communications/business/health services

Tools

Microsoft Office

Adobe

Smartsheets

Ten-key calculator

Job description

Revenue Cycle Specialist – Appeals

Location: Remote, United States

Hourly Compensation: $20 - $22 DOE

Work Schedule: Full-Time, Non-Exempt

SUMMARY

The Revenue Cycle Specialist – Appeals is responsible for performing all aspects of billing and follow-up activities related to Medicare.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Prepare and submit all billings expeditiously.
• Respond to phone and mail inquiries from Medicare.
• Conduct all follow-up activities including handling all correspondence for appeals and fair hearings.
• Process all denials to maximum benefit.
• Adhere to all company policies and procedures.
• Assure that customer problems are handled properly and promptly.
• Process and review assigned queues on a daily basis.
• Review and advise Medicare Supervisor of any and all changes in Medicare regulations or requirements and any issues related to Medicare billing.
• Input claim data information on a daily basis.
• Balance journals periodically.
• Ensure compliance of guidelines provided by Government related agencies and Corporate policies.
• Pass Quality Assurance audits with an accuracy rate of 95% or better.

MINIMUM QUALIFICATIONS

• Minimum of one (1) year prior office work experience
• Minimum of one (1) year medical billing experience
• Experience with ambulance coding and appeals is highly preferred
• Knowledge of HCPCS is preferred
• Prior work experience performing Medicare billing, follow-up, and knowledge of Medicare terminology is highly preferred
• Involvement with Medicare, Medicaid, HMO, and PPO appeals process if preferred
• General working knowledge of PCs and/or patient accounting computer systems is required
• Computer experience and proficiency using Microsoft Office Suite (Word, Excel, etc.), Adobe, and smartsheets
• Experience with website navigation is required
• Must type a minimum of 45 wpm and use a ten-key calculator by touch is required
• Working knowledge of medical terminology and ICD-9 and 10 coding is required
• Must be able to perform duties within tight time constraints and handle large volumes of work
• Must be able to work cooperatively in a team atmosphere

EDUCATION

• High school diploma or GED required
• College courses in psychology, communications, business, and/or health services is preferred

Why Choose AMR?

AMR is one of Global Medical Response (GMR) family of solutions. Our GMR teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services. View the stories on how our employees provide care to the world at www.AtaMomentsNotice.com.

GMR’s Core Behaviors

keep care at the center, raise your hand, seek to understand, find a way together and be accountable unite our teams and set us apart in emergency medical services.

EEO Statement

Global Medical Response and its family of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.

Check out our careers site benefits page to learn more about our benefit options.