Falck Patient Financial Services Billing Specialist - Pre Bill in Mesa, Arizona
Position Summary: The primary job responsibility of the Billing Specialist is to ensure all completed transports are billed through the Falck approved billing system accurately and compliantly to ensure timely reimbursement.
Essential Functions: The Billing Specialist may be assigned one or more duties. These duties may include, but are not limited to, the following:
Interpret EPCR’s received by crews to bill according to the applicable laws set forth by the payor billed.
Track all aspects of missing PCRs, PCSs and determines appropriate processing.
Prepare “as needed” reports for management using PCR, PCS data.
Monitor patient demographics of EPCR and relay information to the operations.
Report findings of trends and developments from specific payors to management.
Track and Analyze the Medical Necessity fields on EPCRs.
Troubleshoot problem areas as identified on reports.
Work with department manager to determine special projects on an as needed basis.
Participate in documentation feedback information for the operations.
Obtain continuous knowledge of CMS regulations.
Make decisions and take appropriate actions based on sound reasoning and judgment.
Contribute ideas; strive to enhance team effectiveness and support decisions made by the team.
Plan and perform work systematically and efficiently.
Carry out instructions, maintain a positive attitude, and support company policies/procedures.
Punctuality and availability for workload.
Comply with HIPAA guidelines
Effectively work through denial/appeal process and meeting filing requirements
Attend and maintain all required Falck USA training
Maintain knowledge of functional area and company policies and procedures
Additional Duties: The Billing Specialist may be assigned one or more additional duties. These duties may include, but are not limited to, the following:
Assist with training new employees
Providing feedback to management concerning possible problems or areas of improvement
Making recommendations to implement improved processes.
Performing other duties as assigned by management.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. 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:
Knowledge, understanding, and compliance with all applicable Federal, State, and Local laws and regulations relating to job duties.
Knowledge, understanding, and compliance with company policies and procedures.
Understanding of health insurance providers, Workers' Compensation, Medicare, Medicaid, and liability claims processes and contracts.
Ability to maintain the highest level of confidentiality.
Proficient personal computer skills.
Excellent interpersonal, written, and oral communication skills.
Ability to work in a team fostered environment.
Ability to multitask and work in a fast paced environment.
Ability to prioritize and organize work.
Ability to adapt to a flexible schedule.
Education Requirements: The individual in this position must possess the following education requirements:
High school diploma or general education degree (GED)
Physical Requirements: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl; talk or hear; and taste or smell. The employee must regularly lift and/ or move up to 15 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
Occasionally: Must have the ability to lift, carry and balance up to 15 pounds.
Frequently: Good manual dexterity, with the ability to perform all tasks related the position
Constantly: Ability to sit and stand for extended periods of time, possess hand-eye-foot coordination and color recognition.
Cognitive/Psychosocial Requirements: The mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Occasionally: Memorization, critical judgment, problem solving.
Frequently: Simple and complex mathematic skills, reasoning, ability to read, interpret and correspond in various written communication formats.
Constantly: Logic, ethical judgment and reasoning, active listening skills, decision making, ability to communicate effectively in written and verbal formats.
Clinical Requirements: N/A
Equipment Operated: The individual in this position must be familiar with using the following equipment to perform the essential functions of this job.
Occasionally: Fax machine, copy machine, calculator
Frequently: Printer, telephone, time clock.
Working Conditions: The working environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Travel approximately 0% of time.
Environmental Conditions: While performing the duties of this job, the employee occasionally works near moving mechanical parts and is occasionally exposed to risk of electrical shock.
The noise level in the work environment is usually moderate.
The statements in this document are intended to describe the general nature and level of work performed by individuals assigned to the classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. This document in no way constitutes a contract of employment. Falck USA reserves the right to modify job descriptions, policies or any other procedural documents at any time, for any reason without prior notice.