Revenue Cycle Specialist

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EMS Management & Consultants, Inc.

WebsiteLinkedInAll Job Openings

501 - 1000 employees

⚕️ Healthcare Insurance

📋 Compliance

☁️ SaaS

Healthcare Insurance • Compliance • SaaS

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

• The Revenue Cycle Specialist is responsible for reviewing and processing claims in various stages of the revenue cycle in a timely and compliant manner • Monitor overall client performance, identify potential loss or delay in revenue to ensure maximized reimbursement for assigned clients • Initiate timely and proactive communication to payers to identify deficiencies and provide appropriate feedback to operational staff in order to resolve and prevent issues • Prioritize, process, and delegate correspondence, rejections, denials, appeals, static claims, and all other follow up on claims in accordance with compliance standards and payer and client specifications • Work independently to define problems, identify causes, and initiate steps necessary for resolution in a timely manner • Regularly meet, and effectively communicate with, Supervisor Claims Management, onshore and/or offshore team members to ensure highest level of reimbursement is achieved • Holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though • Monitor and measure client performance outcomes in comparison to client commitments; identify barriers, seek and suggest solutions when desired outcomes are not achieved • 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.

🎯 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 holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though • Ability to organize, prioritize and multi-task • Ability to learn, understand, and work within specific compliance, client, and 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 tertiary 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 • Strong critical thinking and analytical skills and attention to detail • Proficient in Microsoft Office programs • Proficiency in English is necessary for job-related communication, including understanding policies, writing correspondence, and engaging with colleagues or clients.

🏖️ Benefits

• Individuals in this role are eligible to participate in a discretionary bonus plan • Comprehensive benefit package • Health coverage • Paid time off • Retirement plan