EMS Billing Compliance Specialist
4 weeks ago
Job Summary:
The EMS Billing Audit and Compliance Specialist will be responsible for auditing completed reports by the billing team, resolving escalated issues or special reporting requirements, and ensuring all information is in compliance with laws, regulations, and policies.
This position will work extensively with information protected under HIPAA and requires a high level of discretion.
Key Responsibilities:
- Audit completed electronic patient care reports (EPCR) for accuracy and completeness as needed
- Regularly complete the Medicare Compliance Review, auditing 20% of Medicare-related reports that have gone through the billing stage
- Regularly track and complete the Facilities modifier roster to assist crews in filing reports
- On tickets with outdated information, verify and remove old or incorrect information related to patient demographics and insurance coverage
- Search for payment sources and call types in the ticketing system to identify tickets that need to be worked more urgently or with different procedures
- Evaluate self-pay reports flagged by the billing team, and run Accurint search to obtain additional demographic information needed
- Confirm patient age on self-pay reports to identify guarantor information when needed
- Complete Non-Emergent transfer reports within 72 hours, including the additional forms and information
- Assist the billing team with any escalated concerns, including processing complicated tickets and communication with crews
Requirements:
- High school diploma or equivalent
- One (1) year of experience or education in medical administration, billing, or related fields
- One year of experience with work that included auditing and compliance, mathematics, or a related field
- One year of experience with Microsoft Suite or similar systems
- Must obtain Accurint certification within 90 days as department business allows
Preferred Qualifications:
- Formal coursework in HealthCare billing
- Formal coursework in Microsoft Suite or other applicable computer systems
- Two (2) years of experience in healthcare billing or insurance
- Formal or informal leadership experience
- Notary public
Equal Employment Opportunity:
Sedgwick County is an equal employment opportunity employer and does not discriminate in its programs or services provided to the general public, including employment and all other activities, on the basis of race, color, religion, national origin, citizenship, sex, age, disability, veteran status or any other similarly protected status.
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