[Remote] Patient Insurance Specialist

Note: The job is a remote job and is open to candidates in USA. EMS Management & Consultants, Inc. is seeking a Patient Insurance Specialist to maximize client reimbursement through accurate entry and processing of patient demographic information. The role involves verifying patient insurance details and ensuring compliance with company standards while providing excellent customer service.

Responsibilities

• 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
• 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
• 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

Skills

• 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
• 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

Benefits

• Individuals in this role are eligible to participate in a discretionary bonus plan
• A comprehensive benefit package, including a retirement plan, health coverage, and paid time off

Company Overview