Summary : Oversee the daily operations of the Ins Billing & Collections Dept to ensure compliance with
billing policies and procedures. Monitor and analyze the performance of the collections team while
implementing measures to improve productivity and success rates.
Key Responsibilities
- Responsible for aspects of Insurance Category Billing and Collections for 911
and Non-Emergency Ambulance Service Provider such as verifying insurance
eligibility, billing patients, insurance companies & No-Fault & Worker's Comp
claims.
Responsible for claims submission electronically & via fax, and insuranceportals when required.
Responsible for contacting insurance carriers and following up on outstandingclaims via online, telephone, portals and email.
Identifying, completing, and resolving insurance denials in a timely manner toexpedite claims processing and payment.
Knowledge of insurance EOB's layout / language and requirements for variousinsurance carriers.
Appealing insurance claims when required.Ensuring excellent customer service is provided when following up onoutstanding claims.
Responsible for Appeals creation, submission and follow-ups as required.Liaison between senior management, employees, and clients to ensure properlines of communication are critical in addressing a myriad of problems and issues
requiring immediate attention and resolve.
Review and evaluate Dept processes and procedures, determining appropriateactions to be taken in accordance with company policies and billing practices.
Responsible for assigning daily tasks to Ins teammates and ensuring daily targetgoals are met on a consistent basis.
Reviewing Ins Aging on a daily / weekly basis to identify which tasks requiredpriority review to expedite processing / payment.
Ensure Insurance Category Dept meets / exceeds established cash collection goalson a consistent basis.
Contact Patients / Insurance carriers and take necessary action to ensure timelypayments.
Understanding Customer Service relations to foster an environment of empathywhen contacting patients to ensure debt collections are secured in a timely
fashion.
Provide General administrative and clerical support including but not limited to,receiving, and sorting daily mail, maintaining medical records, faxing, copying,
scanning & stamping outgoing mail.
I NS BILLI NG / C O LL ECT IONS MA N A GE R POSIT I ON DE SCR IPT ION
SE PTE MBE R 20 25
Responsible for training and coaching team members on new and / or existingprocedures.
Responsible for daily / weekly & monthly reporting of following reports : DeptAging, Dept productivity, QA / QI's, Ins Collections Daily Production such as Ins
Claim Status, Ins Denials, Appeals, ETC. Tasks Assignments / Follow Ups, Dept
training refreshers & Internal QA / QI Dept Audits.
Responsible for Ins Refunds account review processes and following refundprocedures with Finance Dept.
Responsible for Evaluations / Plan for Improvements (PFI) and any applicabledisciplinary action when required.
Attending industry Webinars and preparing summary to ensure we are up todate with industry & billing compliance standards.
Responsible for completing Dept projects as assigned.Work closely with Dept Managers / Supervisors to create improvement &implement processes to ensure Dept goals and objectives are met on a
consistent basis.
POSITION QUALIFICATIONS
Education & Experience
College degree or Billing and Coding certification.Maintain working knowledge of ICD-10, CPT and HCPCS coding, NPI, HIPAA, Modifiers, EPCR'sand all forms of medical billing (direct, 3rd party, HMO's, private pay, no-fault, worker's comp,
Medicare & Medicaid
Excellent organizational skills and the ability to multi-task in a fast-paced environmentReview and research data; use intuition and experience to complement data.Thorough knowledge of transport documentation (PCRs)Ability to follow up on outstanding Insurance / Patient accounts.Health Insurance Portability and Accountability Act (HIPAA) requirements and record retentioncompliance.
Excellent written and verbal communications skills requiredExcellent documentation skills(promptness, accuracy, thoroughness, and legibility).
Credit & Collections Procedures, Payment Plan / Settlements / Collection Agency / Ins Paid PtCustomer Service / Debt Collection / Client relations.Waystar / Various Online Ins Portals.Competencies :
Working knowledge of EMS systems / private ambulance and medical transportation systemspreferred.
Knowledge Microsoft Word, Microsoft Excel, PowerPoint, and Microsoft Windows.Familiarity with medical terminologyOrganizational and leadership abilities, detail orientedWork Environment :
Work is performed under normal working conditions, as in a standard office environment.Hybrid position, ability to work from home.Some Saturdays may be required.Physical Requirements :
High level of sitting / working at a deskLight physical effort (lift / carry up to 10 lbs.)Must be able to perform the essential duties of the position with or without reasonableaccommodations.