is a nationally recognized leader in emergency medical transportation billing and reimbursement. QMC is committed to providing services in a manner that ensures compliance with all applicable billing and reimbursement regulations while maximizing the capture of allowable reimbursement for each client. The commitment to adherence to both principles make QMC the partner of choice for emergency medical transportation providers.
This position is 100% work from home.
Summary:
A/R Management Lead
responsibilities will provide support for all revenue cycles related to outstanding insurance accounts receivable, insurance denials and appeals. This includes insurance and patient billing follow up to ensure prompt and correct payment to the client/provider of all monies owed. A/R Management Lead responsibilities will also include working as a subject matter expert identifying process improvements that will bring greater efficiencies within the A/R Management team and a resource for the team to help resolve issues.
Responsibilities:
Perform job responsibilities and tasks according to company standards as well as state and federal guidelines
Be the "subject matter expert" for the AR Management team to use as a resource for denials and appeals
Ability to assess the problem and help bring to resolution
Make telephone calls to patients/hospitals/insurances/facilities/attorneys as needed to research claims or obtain additional insurance information
Contact insurance carriers to inquire about the status of past due accounts
Meet or exceed defined productivity standards
Document details of activity on each account in the claims processing system
Maintaining workflow to keep aging accounts at a minimum by following up on unpaid claims on a regular basis
Ability to think "outside the box" to find solutions
Work assigned special projects designated by the Manager to completion providing reporting and regular updates
Demonstrate the highest level of compliance with all laws and regulations, including but not limited to HIPAA
May require a minimum of 8.5 hours per day.
Other Responsibilities:
Adhere to all QMC HIPAA privacy policies and procedures. This includes always maintaining the confidentiality and security of sensitive patient information.
Ensures consistent adherence to company attendance policies.
Requirements:
Education
High School Diploma required
Associates degree or equivalent experience in Healthcare
Experience
Minimum 3-5 years of experience in healthcare claims processing, billing, or accounts receivable
Hands-on experience preparing and submitting insurance appeals, including understanding payer denial codes and payer timely filing limits
Familiarity with ICD-10, HCPCS, and general medical terminology
EMS billing experience strongly preferred; experience in other medical specialties will be considered
Proficiency with various web platforms, such as billing software and payer portals
Prior customer service experience with the ability to work collaboratively with other departments or team members
Licenses, Certifications & Clearances
Obtain ambulance biller certification within 6 months of employment (provided through QMC)
Knowledge, Skills, Abilities
Excellent computer skills, including Microsoft Word, Excel, and Outlook
Strong verbal and written communication skills
Excellent interpersonal, organizational, and time management skills
Strong problem-solving skills and investigative abilities
Ability to work in a fast-paced, adaptive environment with minimal supervision
Knowledge of collections or medical billing, with a basic understanding of ICD-10, HCPCS, and medical terminology preferred
Effective critical thinking and analytical abilities
* Strong customer service skills and experience
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