Job Description

Description

JOB CLASSIFICATION SUMMARY

The Billing Specialist performs clerical work by verifying information on ambulance ePCRs (Electronic Patient Care Reports), recording information, entering and reviewing data in the system for accuracy, copying, filing and coding EMS ambulance ePCRs for billing insurance carriers or patients. Work requires demonstrated expertise in all phases of medical billing to include accounts receivable management, ICD coding, HCPCS codes, and third-party reimbursement. A qualified candidate must have working knowledge of medical and insurance terminology and must possess interpersonal skills sufficient to interact effectively with patients, families, and payor personnel. The candidate must have the ability to problem-solve, prioritize work, and adapt to changing situations in a fast-paced environment.

Examples of Duties

ESSENTIAL DUTIES
The following are intended to describe core work functions of this classification. While the level and broad nature of essential duties may not change, specific work tasks will vary over time depending on the Town's needs.

• Analyze ambulance transportation care reports for billing compliance, including demographic and insurance billing information. Requests updated face sheets from receiving facility as needed.
• Performs a variety of medical billing-related responsibilities to ensure accuracy of financial data, which may include auditing of medical charts and medical billing, preparing patient refunds, collection accounts and deposits; conducts research; determines and raises pertinent issues, summarizes findings and presents results; and administers programs in assigned area.
• Assists with updating spreadsheets and reports with current fiscal year data, graphs and budget information.
• Assists with the management of associated special revenue accounts, invoicing, and monthly reconciliations.
• Researches, compiles, and creates reports and presentations where routine analysis or technical data is required; notifies appropriate individuals of potential problems based upon complied information and data and recommends potential solutions.
• Participates in a variety of meetings, briefings, trainings, committees, and/or other related groups to provide support in assigned area of responsibility.
• Responds to citizen inquiries regarding all aspects of ambulance billing.
• Completes training of new hire transportation employees in the aspects of billing compliance.
• Respond to inquiries from patients, hospitals, and insurance payers regarding transport claims; setting up payment plans; reviewing hardship requests; explaining and educating patients on the billing process.
• Conducts all activities in a manner that is at all times fair, moral, ethical, and legal.
• Other duties as assigned.

Typical Qualifications

MINIMUM QUALIFICATIONS (at job entry)

Education and Experience:

• Graduation from an accredited college or university with an Associate's Degree in Accounting, Finance, or closely related field; OR any equivalent combination of training, education and experience to provide the requisite knowledge and ability to perform the duties as described.
• Two years of experience in medical or ambulance billing and medical coding.
• Experience with Medicare/Medicaid regulations and laws.

LICENSING/CERTIFICATION REQUIREMENTS

• Certified Ambulance Coder Certification and/or National Ambulance Association Coder Certification - required within one year of employment.
• Individual cannot be on the Office of the Inspector General list of Excluded Individuals / Entities.

KNOWLEDGE

• Medicare, Medicaid, and AHCCS rules and regulations;
• Arizona laws; medical procedures, and diagnostic codes;
• Medical and/or ambulance billing process;
• Familiarity with NEMSIS and Patient Care Reporting Software;
• Data Analysis and presentation;
• Accounting and bookkeeping practices;
• Medical billing principles;
• Standard office equipment including the computer and programs relevant to the performance of applicable duties and responsibilities;
• Applicable general laws, rules, regulations, policies and procedures related to area of assignment;
• Basic research and analysis principles and techniques;
• Customer service principles;
• Word processing methods;
• English language, grammar, and punctuation.

SKILLS

• Gathering and analyzing data sets for billing purposes;
• Understand and perform in accordance with Medicare, Medicaid, and AHCCCS regulations and laws, and departmental policies;
• Recognizing areas for improvement and recommending new procedures, protocol, and training programs to management;
• Communication and interpersonal skills as applied to interaction with coworkers, supervisors, the general public, and other interested parties sufficient to exchange or convey information and to receive work direction;
• Maintaining confidentiality and exercising good judgment in handling sensitive information;
• Composing routine business correspondence;
• Performing multiple tasks simultaneously;
• Communication and interpersonal skills as applied to interaction with coworkers, supervisor, the general public, and other interested parties sufficient to exchange or convey information and to receive work direction.

Supplemental Information

OVERALL PHYSICAL STRENGTH DEMANDS:
Physical Strength for this classification is indicated below with an X
X Sedentary: Exerting up to 10 lbs. occasionally or negligible weights frequently; sitting most of the time.
Light: Exerting up to 20 lbs. occasionally, 10 lbs. frequently, or negligible amounts constantly OR requires walking or standing to a significant degree.
Medium: Exerting 20-50 lbs. occasionally, 10-25 lbs. frequently, or up to 10 lbs. constantly.
Heavy: Exerting 50-100 lbs. occasionally, 10-25 lbs. frequently, or up to 10-20 lbs. constantly.
Very Heavy: Exerting over 100 lbs. occasionally, 50-100 lbs. frequently, or up to 20-50 lbs. constantly.

PHYSICAL DEMANDS:
C F O R N
Continuously Frequently Occasionally Rarely Never
2/3 or more time 1/3 to 2/3 of time Up to 1/3 time
1 hour per week Never occurs
Note: This is intended as a description of the way the job is currently performed. It does not address the potential for accommodation.
Physical Demand Brief Description C F O R N
Standing Communicating with co-workers, observing work site, observing work duties X
Sitting Desk work X
Walking To other departments/offices/office equipment X
Lifting Supplies, files X
Carrying Supplies, files X
Pushing/Pulling File draws, tables and chairs X
Reaching For supplies, for files X
Handling Paperwork X
Fine Dexterity Computer keyboard, telephone pad, calculator, calibrating equipment X
Kneeling Filing in lower drawers, retrieving items from lower shelves/ground X
Crouching Filing in lower drawers, retrieving items from lower shelves/ground X
Crawling Under equipment X
Bending Filing in lower drawers, retrieving items from lower shelves/ground X
Twisting From computer to telephone, getting inside vehicles X
Climbing Stairs, step stool X
Balancing On step stool X
Vision Reading, computer screen, driving X
Hearing Communicating with co-workers and public and on telephone, listening to equipment X
Talking Communicating with co-workers and public and on telephone X
Foot Controls Driving X
Other (Specify)

MACHINES, TOOLS, EQUIPMENT, SOFTWARE AND HARDWARE:
Standard office equipment; vehicle

ENVIRONMENTAL FACTORS:
D W M S N
Daily Several Times Per Week Several Times Per Month Seasonally Never
Health & Safety Factors D W M S N Health & Safety Factors D W M S N
Mechanical Hazards X Respiratory Hazards X
Chemical Hazards X Extreme Temperatures X
Electrical Hazards X Noise and Vibration X
Fire Hazards X Wetness/Humidity X
Explosives X Physical Hazards X
Communicable Diseases X
Physical Danger or Abuse X
Other (Specify Below

NON-PHYSICAL DEMANDS:
C F O R N
Continuously Frequently Occasionally Rarely Never
2/3 or more time 1/3 to 2/3 of time Up to 1/3 time
1 hour per week Never occurs
Description of Non-Physical Demands C F O R N
Time Pressure X
Emergency Situation X
Frequent Change of Tasks X
Irregular Work Schedule/Overtime X
Performing Multiple Tasks Simultaneously X
Working Closely with Others as Part of a Team X
Tedious or Exacting Work X
Noisy/Distracting Environment X
Other (Specify Below)

PRIMARY WORK LOCATION:
X Office Environment
Warehouse
Shop
Recreation/Neighborhood Center
Vehicle
Outdoors
Combination of Office, Vehicle and Field
Other (Specify Below)

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