Pre Billing Specialist (Reimbursement) in San Diego, CA
Company: American Medical Response
Location: San Diego
Posted on: May 24, 2019
PRE BILLING SPECIALIST (REIMBURSEMENT) IN SAN DIEGO, CA
MORE INFORMATION ABOUT THIS JOB
Job Title: Pre-Billing Specialist (Reimbursements)
Reports To: Supervisor- Billing
Location: San Diego
FLSA Status: Non-exempt
The Reimbursement Specialist (RS) reviews the Computer Aided
Dispatch (CAD) queue and San Diego Health information Exchange
(HIE)for clarity of patient demographics, billing information,
supporting documentation, and information surrounding the patient
encounter prior to unit dispatch. The RS will work closely with
billing personnel as well to improve quality of data gathering
relating to pre-billing authorizations. The RS will also assist
patients with appeals to their insurance when claims are
Essential Duties and Responsibilities:
* Use the San Diego Health Information Exchange system to obtain
patient demographics and billing information.
* Assist patients through appeals to their insurance for claims
that are denied.
* Search other approved systems for additional patient demographics
and insurance information to reinforce crew-captured data.
* Search, as applicable or in addition to the Pre-Billing
Specialist s system, the Jaguar billing system for pre-existing
account. Provide mechanism to update the account or create a new
account as necessary.
* Process customer complaints quickly by receiving, investigating,
redirecting or, resolving the issue.
* Convey an attitude of intolerance for unprofessional
* Develop and sustain excellent working relationships with AMR
professionals (e.g., Operations, PBS, Business Development, IT and
Finance), as well as with the Company s clients, payors,
consultants, banks and financial intermediaries and government
* Adhere to all company policies and procedures.
* Adhere to and comply with information systems security. Know and
follow Information Systems security policies and procedures, attend
Information Systems security training, and report information
systems security problems if identified.
* Complete other duties as assigned.
Non-Essential Duties and Responsibilities:
* Communicate a willingness to help others succeed.
* Demonstrate and promote a spirit of teamwork and cooperation.
* Convey and inspire a sense of competence and commitment.
* Use initiative to learn new skills, enhance personal knowledge
and improve communications.
* Demonstrate an ability to communicate and work well with others
(e.g., customers, facilities, AMR Operations, and payors).
* Seek opportunities to improve the work environment.
* Perform other duties as assigned.
Education/Licensing/Certification: High School diploma or GED
required; EMT certification/licensure or medical experience
5 years experience conducting extensive pre-billing processes,
including research, resolution and payor contacts, demonstrated
ability to function effectively in a high performance, high call
volume billing environment. Demonstrated ability to function within
multiple payor platforms including San Diego, Medicare, HMO s,
SNF/IFT, private pays and hospital specific payor plans across
Experience: Work with computer programs and software preferred;
work with general public preferred; experience in medical industry
preferred. 5 years experience as pre-biller.
Knowledge & Skills:
* Above average knowledge of medical and insurance industry
* Above average understanding of HIPAA, Sarbanes-Oxley and other
critical governmental regulations within one (1) month of hire
* Maintain working knowledge of various tools including but not
limited to basic Microsoft Office software, QWERTY keyboard use,
basic computer function.
* Communicate clearly in English, both verbally and in writing, to
convey information distinctly and concisely. Use appropriate
grammar and punctuation in written documents.
EOE including Veterans and Disabled
Keywords: American Medical Response, Chula Vista , Pre Billing Specialist (Reimbursement) in San Diego, CA, Accounting, Auditing , San Diego, California
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