Revenue Cycle Specialist

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EMS Management & Consultants, Inc.

WebsiteLinkedInAll Job Openings

501 - 1000 employees

💼 Consulting

🏥 Healthcare

⚕️ Healthcare Insurance

Consulting • Healthcare • Healthcare Insurance

EMS Management & Consultants, Inc. (EMS|MC) is a company that specializes in providing comprehensive operational solutions for over 1,500 emergency medical services (EMS) providers across the United States, including hospital systems, municipalities, and private companies. Founded by professionals within the EMS industry, EMS|MC offers services designed to optimize reimbursement, resources, and regulatory compliance. With more than 25 years of experience, the company leverages technologies like EMsmart, a SaaS-driven billing solution, to enhance revenue performance for EMS agencies. EMS|MC also works closely with the PWW Advisory Group to ensure compliance with the ever-changing regulatory landscape, providing tools and educational resources to EMS providers.

📋 Description

• Review and process claims through various stages of the revenue cycle in a timely and compliant manner • Monitor client performance and identify potential revenue loss or delay • Seek and suggest solutions to maximize reimbursement and client performance • Provide feedback on client performance, workflows, processes, trends, industry changes, payer regulations, and concerns • Communicate proactively with payers to identify deficiencies and help resolve and prevent issues • Prioritize, process, and delegate correspondence, rejections, denials, appeals, static claims, and other claim follow-up • Determine the appropriate next action for each claim and follow issues through resolution • Meet and communicate with the Supervisor Claims Management and onshore/offshore team members • Ensure reimbursement through work prioritization and adherence to standard operating procedures and vendor SLAs • Analyze client performance outcomes against commitments and identify barriers to desired outcomes • Stay informed about industry changes and regulations • Build and maintain internal and external customer relationships • Present client performance analysis as needed • Serve as backup to other team members • Perform other duties and tasks as assigned

🎯 Requirements

• High School Diploma • At least 1–2 years of experience processing health insurance claims and/or denials or other healthcare accounts receivable experience, or 1–2 years of medical billing experience, or at least 1 year of EMS billing experience • Ability to analyze client performance using big-picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and timely follow-through • Ability to organize, prioritize, and multitask • Ability to learn, understand, and work within compliance, client, and payer requirements • Commitment to continuous improvement • Understanding of applicable HIPAA regulations, Medicare, Medicaid, insurance, liability, and tertiary payment methods • Adaptability to changes in work environment, procedures, priorities, and duties • Ability to function within a cross-functional team and independently • Strong critical-thinking and analytical skills and attention to detail • Proficiency in Microsoft Office programs • Proficiency in English for job-related communication • Strong preference for prior EMS billing and/or denials experience • Proficiency in EMS|MC billing software • Authorization to work in the United States now and in the future; no current or future visa sponsorship

🏖️ Benefits

• Discretionary bonus plan • Comprehensive benefit package • Retirement plan • Health coverage • Paid time off • EMS|MC provides necessary equipment, including a computer, monitor, keyboard, mouse and headset • Reasonable accommodations for qualified individuals with disabilities