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Responsibilities
The Billing Specialist II (BSII) plays an important and fundamental role in Digitech’s RCM process by ensuring claims are coded and billed accurately and on time. The BSII must maintain a strong working knowledge of billing rules and regulations for all payor types across the various regions in which they process claims. The BSII must be detail-oriented and driven by the highest quality standards. The BSII is a second-level, more experienced Billing Specialist who consistently performs as a top producer in both daily production and quality metrics.Essential Duties and ResponsibilitiesUtilize Master Billing Guides and other process instructions to review PCR to ensure medical necessity, reasonableness. appropriate modifiers, level of service, ICD10 code and mileageComplete the Billing quality scrub processReview PCS for validity, if requiredReview Medicare AOB, if requiredIf additional information is needed, place claim on appropriate tagAttends and actively participates in daily Billing team huddlesConsistently achieves Billing Specialist II performance and quality metricsProvide accurate billing in compliance with regulatory requirements and internal policies and proceduresDemonstrate biller competency by achieving and maintaining billing accuracy scores that meet or exceed expectations during quality assurance and audit activitiesAdhere to all Digitech HIPAA privacy policies and procedures. This includes always maintaining the confidentiality and security of sensitive patient informationAdditional job duties as assignedSkills/Experience RequiredEducation: High School Diploma or equivalent2+ years EMS Billing preferredCertified Ambulance Coder (CAC) preferredDemonstrated ability or willingness to attain QMC Biller Certification upon employmentVery detail-orientedStrong, working knowledge of EMS billing rules and regulations and understanding of health insurance payor groups (Medicare, Medicaid, Commercial)Ability to identify problems and escalate issues appropriately to a Billing LeadAbility to quickly adapt, learn and retain changing rules and specifications by clients, payors, states and MAC regionsQuality-focused and driven by processEMS billing platform knowledge (preferred)Ability to independently manage all aspects of the job role including required goals and business practices in a remote environmentSarnova is an Equal Opportunity Employer. We offer a competitive salary, commensurate with experience, along with a comprehensive benefits package, including 401(k) Plan.
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