Responsible for executing an array of daily processes and procedures designed to support and facilitate the efficient flow of timely and accurate information to all departments within the company.

Responsibilities

• Mail Processing
• Electronic File Submissions
• Payment & Check Handling
• Insurance & Demographics Verification
• Patient Care Report (PCR) Management
• Membership verification and processing

Attributes & Qualifications

• Computer familiarity: Microsoft office applications, database and spreadsheet applications, internet/webpage navigation, scanning & indexing
• Medical claims and insurance familiarity: explanation of medical benefits, payment structures of federal, commercial, automobile, HMO/MCO insurances
• Time management & prioritization skills

• Multi-task & meet deadlines
• Positive attitude and resilience
• Attention to detail
• Ability to work in a team environment
• Self-starter with the ability to streamline functions and passion to learn, grow and share knowledge and information

Responsible for investigating and efficiently resolving an array of account issues across all major payers, from Medicare to Medicaid, commercial insurers, facilities, and directly with patients.

Responsibilities

• Initiate phone calls to carriers for claim status, denials and status of payment
• Submit claims to carriers and patients to secure payment on outstanding balances
• Identify and submit appeals to carriers for redetermination of claims
• Process claim rejections via clearinghouse
• Process incoming correspondence for all insurance payer types
• Perform all necessary duties to successfully secure payment and close a claim
• Validate and qualify refunds for processing
• Manage applicable claims resolution workflows
• Communicate new industry information and procedures as learned through your daily workflow functions
• Provide direct supervisor with ideas and suggestions for system updates and procedural improvements
• Complete departmental related projects as needed
• Complete all additional duties as assigned

Attributes & Qualifications

• Understanding of insurance, Medicare and Medicaid billing procedures and general practices
• Ambulance billing guidelines and regulations
• Collection law and guidelines
• General computer proficiency and knowledge of Microsoft Office applications
• Math, grammar, and spelling proficiency
• Excellent time management and prioritization skills
• Ability to multitask and meet deadlines
• Maintain positive attitude and flexibility
• Good customer service and persistence
• Strong communicator, written and verbal
• Detail oriented and accurate
• Investigative nature with problem solving skills
• Team player

Responsible for providing customer service and account oversight to a group of clients, through rapport building, efficient workflow maintenance, monitoring of various reports, and onsite consultations.

Responsibilities

• Understand the EMS industry
• Understand the ambulance billing industry
• Understand how Cornerstone operates
• Develop strong professional relationships
• Communicate effectively with decision makers
• Smartly manage their time based on an ever-changing workload
• Be a positive influence on others through their attitude and work ethic

Attributes & Qualifications

• Three or more years in a client-facing role
• EMS background preferred
• Four-year degree preferred
• Proficient in Microsoft Office

Responsible for coding, incorporating an array of technical, clinical and regulatory knowledge to interpret client documentation and translate it into the most appropriate claim.

Responsibilities

• Read and interpret transport and clinical data to ensure proper documentation has been provided to accurately generate a clean claim
• Use clinical data to determine the medical necessity of an ambulance transport
• Proper application of HCPCS and ICD10 codes to properly classify conditions related to the complaints communication during an patient encounter
• Accurately and timely transcription of data from various client ePCR trip programs into our billing program, RescueNet dispatch
• Identify the need to request additional or missing information from various sources such as Client Services, hospitals, insurances, Skilled Nursing and Custodial extended care facilities when applicable
• Obtain and update patient information including, demographics, and insurance information
• Workflow management
• Responds to interdepartmental inquiries regarding CMS billing principles and industry-related regulations, practices and client specifications
• Provide direct supervisor with ideas and suggestions for system updates and procedural improvements
• Complete departmental related projects as needed
• Complete all additional duties as assigned

Attributes & Qualifications

• Certification in Medical Billing and Coding, Healthcare; or equivalent combination of education and experience
• Understanding of medical terminology/abbreviations, anatomy and physiology, insurance, Medicare and Medicaid billing procedures and general practices
• Ambulance billing guidelines and regulations
• General computer proficiency and knowledge of Microsoft Office applications
• Math, grammar, and spelling proficiency
• Ability to process high volume of data on a day-to-day basis
• Ability to multitask and meet deadlines
• Maintain positive attitude and flexibility
• Strong communicator, written and verbal
• Detail oriented and accurate
• Approaches change as an opportunity for growth and development in self and others
• Team player

 Responsible for inbound and outbound phone calls to patients to resolve unpaid ambulance medical bills.

Responsibilities

• Provide superior customer service to all incoming phone calls
• Assist patients calling with all applicable billing related needs, such as insurance information, payment plans, hardships, membership terms, referral to collections, etc.
• Document billing software with all inbound and outbound calls
• Update billing software with all applicable insurance and patient demographics received via mail, phone, email, fax, website submission
• Initiate phone calls to patients for unpaid accounts
• Develop payment plan techniques for delinquent accounts
• Submit invoices to bill patients to secure payment on outstanding balances
• Verify insurance eligibility via various online platforms
• Process incoming patient correspondence via mail, fax, and email
• Manage applicable claims resolution workflows
• Communicate new industry information and procedures as learned while working claims
• Provide direct supervisor with ideas and suggestions for efficiencies, system updates and procedural improvements
• Complete departmental related projects as needed
• Complete all additional duties as assigned

Attributes & Qualifications

• Knowledge or understanding of insurance, Medicare and Medicaid billing procedures and general practices
• Ambulance billing guidelines and regulations
• Collection law and guidelines
• General computer proficiency and knowledge of Microsoft Office applications
• Math, grammar, and spelling proficiency
• Superior customer service skills and persistence
• Excellent time management and prioritization skills
• Ability to multitask and meet deadlines
• Maintain positive attitude and flexibility
• Strong communicator, written and verbal 
• Detail oriented and accurate 
• Investigative nature with problem solving skills
• Team player

Responsible for accurate and efficient payment posting, application of contractual allowances and write-offs, refund adjudication, split payment verification, and the weekly reconciliation of business and banking activity.

Responsibilities

The primary responsibility of these specialists is the posting of all payments received throughout the billing cycle.

• Payment types posted include checks, credit cards, ACHs and electronic funds transfers.
• Payments received from payers such as Medicare, Medicaid, Commercial Insurance, Hospitals and Private Pay Patients.
• Payments are reconciled against a Remittance Advice and/or Explanation of Benefits, Federal and State EMS laws and client specifications.

Additional responsibilities include: 

• Apply write‐offs, contractual allowances and other adjustments to the claim at the time of payment posting
• Process refunds and cut checks to applicable payers
• Process reconciliation of electronic deposits to clients
• Appeal and contest applicable payments
• Process incoming mail

Scan and electronically index documents

Attributes & Qualifications

Knowledge:

• Understanding of insurance, Medicare and Medicaid billing procedures and practices
• Ambulance billing guidelines and regulations
• Collection law and guidelines
• Computer proficiency and knowledge of Microsoft Office applications

Skills/Attributes:

• Proficiency of keyboarding numerical data
• Mathematical, calculation and reconciling skills
• Detail oriented and accurate
• Excellent time management and prioritization skills
• Ability to multitask and meet deadlines
• Maintain positive attitude and flexibility
• Team player