EMS Revenue Specialist

Overview

EMS Revenue Specialist 

The EMS Revenue Specialist is responsible for working directly with the Health Insurance Companies to resolve open balances.  This could include but not limited: utilizing payer portals to check claim status, updating patients’ insurance policy, reviewing / updating the ICD-10 code listed, sending corrected claims and/or appeals.  

All representatives will conduct insurance verification as needed and are required to complete prebilling training to qualify for the role.  

Responsibilities

Responsibilities of the EMS Revenue Specialist 

• Places and receives calls regarding billing insurance questions and other patient service activities.  

• Process accounts according to the action required to resolve account balances. 

• Resolving insurance carrier denials, appealing claims, contacting carriers on open accounts, and responding to insurance carrier correspondence and/or inquiries. 

• Comfortable communicating with any caller including customers, agencies, facilities, and hospitals. 

• Employ one-step resolution practices for clients and patients through open lines of communication. 

• Research patient accounts to verify all health insurance coverages. Audit patient accounts to verify proper billing process was followed. 

• Compute adjustments based on EOB's remittance and insurance contracts. 

• Ensure accuracy in data entry and consistent attention to detail. 

• Collect outstanding balances as well as identify, address, and resolve account discrepancies while following company policy and procedures. 

• Demonstrates knowledge and compliance of insurance, local, state, and federal billing. 

• Ability to complete tasks efficiently both individually and in a group environment. 

• Handle assigned correspondence fulfilling any other duties as assigned by managerial staff. 

Key Skills of the EMS Revenue Specialist  

• Well-versed with medical billing practices that include an understanding of insurance billing codes, regulations, and procedures.  

• Ability to investigate and resolve software issues, billing errors and disputes.   

• Effective communication skills with clients, insurance companies, patients, staff members and management.   

• Ability to manage multiple tasks and meet deadlines.  

• Must have great attention to detail with high accuracy.  

Qualifications

Qualifications of the EMS Revenue Specialist 

• College preferred but not required. 

• Minimum two years’ experience in customer care, account management or similar role. 

• Ability to read and understand the Explanation of Benefits or Electronic Remittance Advice. 

• Understands the difference between rejections and denials as well as working accounts. 

• Healthcare knowledge is preferred. 

• Must be a quick learner and motivated individual with excellent verbal communications skills. 

• Ability to “multi-task” and manage spurs of high call volume / stress. 

• Positive, can-do attitude and with good judgement demonstrating ability to escalate account when needed. 

• Ability to receive and implement feedback. 

Computer and Office Qualifications of the EMS Revenue Specialist 

• Computer literacy is a must;  Typing skillset of at least 45 WPM is highly desired 

• Experience working in an active office environment. 

• Must be able to work with 2 monitors and split screens to operate multiple sites simultaneously. 

• Must be able to sit / stand for 8 hours minimum in an office environment 

• Must be able to use Word, Excel Spreadsheet, Email, Chat Applications, and other software applications. 

• Must be able to read, comprehend, and apply job-related rules, policies, and procedures. 

Benefits

• Opportunities for career advancement
• Competitive wages
• Ability to receive on demand pay before pay day
• 401(k) with company contribution
• Medical, Dental, Vision & Life Insurance
• Voluntary Insurance (short-term disability, critical illness, accidental & legal)
• Company Paid Life Insurance and Long-Term Disability
• Paid vacation & sick time
• Holiday pay
• Referral bonus available 

Salary or Wage Range