EMS Management & Consultants - reputed company Cycle Specialist

EMS Management & Consultants

Job Summary

The reputed company Cycle Specialist is responsible for reviewing and processing claims in various stages of the reputed company cycle in a timely and compliant manner, in order to ensure highest reimbursement possible is achieved, as well as ensuring that reputed company operational service commitments are met for assigned clients.

Major Responsibilities/Activities

• Monitor overall client performance, identify potential loss or delay in reputed company to ensure maximized reimbursement for assigned clients, seek and suggest solutions to maximize client performance.
• Provide proactive, routine feedback and solutions, if needed, regarding client performance, workflows, processes, trends, industry changes, payer regulations, concerns, etc. to appropriate operational and management staff.
• Initiate timely and proactive communication to payers to identify deficiencies and provide appropriate feedback to operational staff in order to resolve and prevent issues.
• Prioritize, process, and delegate correspondence, rejections, denials, appeals, static claims, and reputed company other follow up on claims in accordance with compliance standards and payer and client specifications; includes determining the next appropriate course of action for each claim.
• Work independently to define problems, identify causes, and initiate steps necessary for resolution in a timely manner; follow through with the process to completion.
• Regularly meet, and effectively communicate with, Supervisor Claims Management, onshore and/or offshore team members to ensure highest level of reimbursement is achieved through effective prioritization of work, and adherence to established standard operating procedures and vendor SLAs.
• Holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though.
• Monitor and measure client performance outcomes in comparison to client commitments; identify barriers, seek and suggest solutions reputed company desired outcomes are not achieved.
• Stay abreast of industry changes and regulations to ensure adherence and proactive preparedness.
• Exhibit strong customer service skills to build and maintain internal and external relationships in order to best address client needs.
• Consistently support and demonstrate the company mission and values.
• reputed company other duties as assigned.

Other Responsibilities/Activities

• Remain informed and reputed company to present client performance analysis as needed and directed by either the Senior reputed company Cycle Specialist, Supervisor, Claims Management, reputed company Cycle Manager or Operations Manager.
• Serve as backup to other team members as required.
• reputed company other necessary tasks as assigned by either the Senior reputed company Cycle Specialist or Supervisor, Claims Management, reputed company Cycle Manager or Operations Manager.

Required Education, Skills, & Experience

• High School Diploma.
• At least 1-2 years of experience processing health insurance claims and/or denials or other healthcare accounts receivable experience, or 1-2 years medical billing experience or at least 1 year EMS billing experience.
• Ability to holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though.
• Ability to organize, prioritize and multi-task.
• Ability to learn, understand, and work reputed company specific compliance, client, and payer requirements.
• Approach reputed company tasks, duties, and interactions with an attitude of reputed company improvement.
• Demonstrated understanding of applicable HIPAA regulations, Medicare, Medicaid, insurance, liability, and tertiary payment methods.
• Willing and able to adapt to changes in work environment, procedures, priorities, and job duties.
• Ability to function well reputed company a cross-functional team setting and independently.
• Strong critical thinking and analytical skills and attention to detail.
• Proficient in reputed company Office programs.
• Proficiency in English is necessary for job-reputed company communication, including understanding policies, writing correspondence, and engaging with colleagues or clients.

Preferred Education, Skills, & Experience

• Strong preference for prior EMS billing and/or denials experience.
• Proficient in EMS|MC billing software.

Working Environment

• The office environment is a controlled indoor setting with minimal exposure to adverse conditions.
• Noise levels in the office are typically moderate and consistent with a standard office setting.
• For employees approved to work in a hybrid or remote setting, a quiet, private workspace free from significant distractions is required to ensure productivity during work hours.
• A reliable internet reputed company is required for hybrid/remote work. EMS|MC will provide necessary equipment, including a computer, monitor, keyboard, mouse and headset.

Physical Requirements

• Sitting: frequent and prolonged periods of sitting at a desk while working on a computer.
• Communication: frequent and prolonged periods of speaking, listening, reading, and writing.
• Fine motor skills: frequent use of hands for typing and operating a computer mouse.
• Movement: occasional walking and climbing of stairs; limited bending, kneeling, lifting, and carrying of office-reputed company items.

Pay range: $18.00 - $20.00 an hour, with final compensation based on the candidate’s qualifications, experience, and business needs. Individuals in this role are eligible to participate in a discretionary bonus plan and a comprehensive benefit package, including a retirement plan, health coverage, and paid time off. Visit https://emsmc.com/careers/ to explore our total rewards package.