Quick Med Claims - Billing Specialist I en Quick Med Claims

Quick Med Claims (QMC) 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:

The Billing Specialist I will utilize master billing guides and other process instructions to review PCR to ensure medical necessity, reasonableness, level of service, ICD10 coding and mileage is correct. This role is fundamental in QMC's revenue cycle management process and ensures that claims are coded and billed accurately and timely. The selected Billing Specialist I will maintain a strong working knowledge of billing rules and regulations for all payor types in the various regions for which they process claims.

Responsibilities:

• Review patient medical records and supporting documentation.
• Add required data elements to the account in the billing platform, including ICD-9 codes, charges, and billing narratives.
• Ensure all tasks are completed in accordance with Quick Med Claims policies as well as state and federal guidelines.
• Meet or exceed defined productivity standards for the position.
• Properly notate accounts reviewed.
• Attach necessary documentation within the system or to paper 1500s.
• Obtain additional information from clients when needed, such as HIPAA forms, pre-authorizations from insurance companies, and physician medical necessity forms, in order to submit third-party claims.
• Review billing documents in the billing platform using dates provided on patient care reports, physician medical necessity forms, and hospital face sheets.
• Review and validate claims electronically or on paper.
• Monitor tags or workflows to ensure timely validation of claims.
• Process all insurance claim forms in accordance with federal and state laws as well as departmental procedures.
• Provide accurate billing in compliance with regulatory requirements and internal policies and procedures.
• Demonstrate biller competency by achieving and maintaining billing accuracy scores that meet or exceed expectations during quality assurance and audit activities.

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.

Education:

• High school diploma or equivalent

Experience:

• 1 – 2 years of Medical billing preferred

Licenses, Certifications & Clearances:

• Certified Ambulance Coder (CAC) preferred
• QMC Biller Certification preferred

Knowledge, Skills, Abilities:

• Must be able to type 35 wpm
• Basic computer skills including ability to utilize multiple windows and programs simultaneously 
• Customer service oriented 
• Attention to detail and focus on quality
• Organizational skills
• Must display sufficient written and oral communication skills
• Must have the ability to work in a fast-paced environment
• Must have the ability to work with minimal supervision