EMS Management & Consultants, Inc. · 3 months ago
Facilities Revenue Cycle Specialist
Winston Salem,NC,US
Full-time
Onsite
Entry Level
1+ years expEMS Management & Consultants, Inc. is seeking a Facilities Revenue Cycle Specialist to manage and process facility claims throughout the revenue cycle. The role involves monitoring accounts receivable, communicating with facility payers, and ensuring compliance with operational service commitments to achieve maximum reimbursement for clients.
ConsultingInformation Technology
Responsibilities
Monitor and analyze outstanding facility accounts receivable for assigned clients while suggesting solutions to maximize client performance
Initiate timely and proactive communication to facility payers to identify deficiencies and provide appropriate feedback to operational staff in order to resolve and prevent issues
Prepare, review, and send invoices to facility payers on a monthly or other specifically noted interval
Ensure special invoice processes are documented and completed as required by facility
Maintain a list of contacts for each facility to establish open communication and increased responsiveness
Work independently to define problems, identify causes, and initiate steps necessary for resolution in a timely manner; follow through with the process to completion
Regularly meet and effectively communicate with Supervisor Claims Management and Revenue Cycle Managers to ensure highest level of reimbursement is achieved through effective prioritization of work and adherence to established standard operating procedures and vendor SLAs
Holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though
Stay abreast of industry changes and regulations to ensure adherence and proactive preparedness
Exhibit strong customer service skills to build and maintain internal and external relationships in order to best address client needs
Conduct all job tasks, calls, 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
Remain informed and prepared to present client performance analysis as needed and directed by either the Senior Revenue Cycle Specialist, Supervisor, Claims Management, Revenue Cycle Manager or Operations Manager
Serve as backup to other team members as required
Perform other necessary tasks as assigned by either the Senior Revenue Cycle Specialist or Supervisor, Claims Management, Revenue Cycle Manager or Operations Manager
Maintain or exceed specified performance standards for each client, to include but not limited to Contracted Service Level Agreements, Account Review Aging, monitoring of incoming facility payments and facility payer education regarding consolidated billing
Qualification
Required
High School Diploma
At least 1-2 years of experience processing health insurance claims and/or denials or other healthcare accounts receivable experience, or knowledge of facility billing and consolidated billing guidelines
Ability to organize, prioritize and multi-task
Ability to learn, understand, and work within specific compliance, client, and facility payer requirements
Approach all tasks, duties, and interactions with an attitude of continuous improvement
Demonstrated understanding of applicable HIPAA regulations, Medicare, Medicaid, insurance, liability and facility payment methods
Willing and able to adapt to changes in work environment, procedures, priorities, and job duties
Ability to function well within a cross-functional team setting and independently
Detail-oriented
Resourceful
Self-starter
Must possess critical thinking/analytical skills
Proficient in Microsoft Office programs
Preferred
Strong preference for knowledge of prior health insurance claims and/or denials experience and/or facility billing
Company
EMS Management & Consultants, Inc.
EMS|MC is the largest billing services provider focused exclusively on emergency medical services in the United States.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2021-11-30Acquired
2007-03-01Private Equity
Leadership Team
Jay Gyure
Chief Financial Officer
Jason Brantley
Chief Customer Officer
Recent News
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