Revenue Cycle Specialist

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $17 - $20 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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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 delays to maximize reimbursement • Suggest solutions to improve client performance, workflows, processes, and outcomes • Provide proactive feedback regarding client performance, industry changes, payer regulations, and concerns • Communicate with payers to identify deficiencies and provide feedback to operational staff • Prioritize, process, and delegate correspondence, rejections, denials, appeals, static claims, and other claim follow-up • Determine the appropriate next action for each claim • Define problems, identify causes, and independently initiate and complete resolutions • Meet and communicate with Claims Management supervisors and onshore/offshore team members • Ensure effective work prioritization and adherence to standard operating procedures and vendor SLAs • Monitor and measure client performance against commitments and address barriers to desired outcomes • Stay current on industry changes and regulations • Build and maintain internal and external relationships to address client needs • Present client performance analysis as directed • Serve as backup to other team members • Perform other duties 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 medical billing experience, or at least 1 year EMS billing experience • Ability to utilize big-picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow-through • Ability to organize, prioritize, and multitask • Ability to learn, understand, and work within specific compliance, client, and payer requirements • Commitment to continuous improvement • Understanding of applicable HIPAA regulations, Medicare, Medicaid, insurance, liability, and tertiary payment methods • Willingness and ability to adapt to changes in work environment, procedures, priorities, and job duties • Ability to function within a cross-functional team setting and independently • Strong critical thinking, analytical skills, and attention to detail • Proficiency in Microsoft Office programs • Proficiency in English for job-related communication • Preferred: prior EMS billing and/or denials experience • Preferred: proficiency in EMS|MC billing software • Authorized 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-provided computer, monitor, keyboard, mouse, and headset • Reasonable accommodations for qualified individuals with disabilities