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Falck Patient Financial Services Billing Specialist-Post Bill in Mesa, Arizona

Position Summary:

The Postbill specialist is responsible for timely follow up on insurance claims after the initial sent claim, in order, to facilitate payment from the appropriate source in a timely manner. Duties for this position are outlined below. The Postbill representative should be knowledgeable in the life-cycle of a claim and the expectation of a variety of payors.

Essential Job Duties:

The PostBill Specialist may be assigned one or more duties. These duties include, but are not limited to, the following:

  • Sorts and Responds timely and accurately to all incoming insurance correspondence and inquiries

  • Initiates contact with patients, as necessary to obtain insurance information

  • Responds to all phone calls from other departments or insurance companies in an efficient and courteous manner

  • Updates patient accounts based on verified information from the patient/guarantor or other valid method

  • Prepares correspondence to payer as necessary

  • Utilize Passport and/or other methods of insurance verification as appropriate

  • Verifies eligibility and insurance benefits for old billing patients to ensure appropriateness

  • Research calls/accounts and determine the nature of any problem in payment on the account when required.

  • Follows-up on all assigned accounts from within the RescueNet systems in accordance with pre-established goals

  • Researches and analyzes accounts and payments; reverses balances to credit or debit if charges were improperly billed or if payments were incorrect

  • Ensures that all conditions for payment receipt have been satisfied, which includes, but is not limited to, accurate charges and payor category; authorization/certification/TAR information; claims address; ICD and HCPCS coding; patient insurance eligibility, patient benefit coverage; patient responsibility

  • Evaluates accounts to determine any write-offs or corrections required, including duplicate charges

  • Submits claims for secondary payment, as appropriate

  • Prepares refund requests for any monies due to patient or insurance company

  • Identifies any charge correction needs and initiates proper request forms

  • Documents appropriate comments/notes in RescueNet for every call, including any action taken

  • Appropriately communicates with patient to determine financial status, as necessary, discussions with collections &/or PFS to determine payment plans

  • Interprets billing questions and provides clarification

  • Thoroughly work Aging reports as directed

  • Claim status by phone or online

  • Know when to file appeal

  • Recognize and post denials

  • Review/work payor correspondence accordingly

  • Research payor specific information, online, in provider manuals, and by calling payors

  • Review claim for accuracy (as needed), must have a basic understanding of the Prebill functions (i.e. signature rules, icd-9 coding, modifiers, etc.)

  • Navigate through Paperclip to locate supporting documentation that may be relative to the billing process (i.e. EMS Report, medical records, EOB, etc.)

  • Ensure the proper payor has been added and select the appropriate next schedule and/or event

  • Request refunds

  • Respond to payor correspondence in a timely manner

  • Grade the Invoicers using Frequent Note Types that have been established in the database

  • Provide essential feedback in assuring future claims are sent clean

  • Adjustments

  • Special follow-up projects

  • Other duties as assigned by Billing Supervisor &/or Manager

Communication:

  • Meets regularly with Supervisor and or Manager

  • Handles in a professional and confidential manner all correspondence, documentation and files

  • Meets daily and weekly productivity standards

  • Elevates issues, as appropriate, to the Supervisor and/or Manager

  • Supports Care Ambulance/Falck USA core values, policies, and procedures

  • Works in a professional and courteous manner with all co-workers in our organization and others to obtain required information on a timely basis and to solve outstanding issues, as appropriate

Productivity Standard:

  • Productivity will vary depending on specific payor category the PostBill Specialist is responsible for; minimum calls followed up on daily should be 45. Productivity will be further defined for this position by the Billing Manager. The assigned productivity standards should be the minimum, we should be striving to meet the higher end of the range.

Qualifications:

To perform this job successfully, an individual must be able to adequately perform each essential duty. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The individual in this position must possess the following qualifications:

  • High school diploma or equivalent; Two years of Medical Billing and Collection experience

  • At least (3) years of experience in medical billing/collections and/or insurance payer follow-up experience

  • Must be computer literate; Intermediate experience in Excel

  • Able to work in a team-oriented environment

  • Skilled in data entry.

  • Ability to type a minimum of 45 wpm.

  • Analytical skills as needed

  • Must have knowledge of medical terminology.

  • Excellent interpersonal and customer service skills.

  • Ability to communicate, both orally and in writing, in a professional manner when dealing with employees and management.

  • Well organized and detail oriented.

  • Ability to research and resolve problems

  • Ability to successfully work independently.

  • Ability to handle multiple tasks and to prioritize their importance.

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