Revenue Cycle Specialist @Ems Management Consultants

[Hiring] Revenue Cycle Specialist @Ems Management Consultants

Mar 28, 2025 - Ems Management Consultants is hiring a remote Revenue Cycle Specialist. 💸 Salary: unspecified. 📍Location: USA.

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Role Description

Review and process claims in various stages of the revenue cycle in a timely and compliant manner, in order to ensure highest reimbursement possible is achieved, as well as ensuring that all operational service commitments are met for assigned clients.

Monitor overall client performance, identify potential loss or delay in revenue 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 all 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 when 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
Conduct all job tasks, calls, duties, and interactions with professionalism, respect, a positive attitude, and in accordance with company compliance policies and applicable government regulations
Consistently support and demonstrate the company mission and values

Requirements

Maintain or exceed specified performance standards for each client, to include but not limited to Contracted Service Level Agreements, A/R Aging, Net Collection Percentages, Average Cash Per Trip, Denials, Rejections, Account Review Aging, and maintaining a 96% audit score monthly.

Qualifications

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 within specific compliance, client, and payer requirements
Approach all tasks, duties, and interactions with an attitude of continuous 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 within a cross-functional team setting and independently
Detail-oriented
Resourceful
Self-starter
Must possess critical thinking/analytical skills
Proficient in Microsoft Office programs

Benefits

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

Working Environment/Physical Requirements

General office environment
Frequent typing
Sitting, standing, walking
Use of basic office equipment such as computer, fax, printer, copier, and telephone

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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Revenue Cycle Specialist @Ems Management Consultants

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Salary 💸 unspecified	Remote Location USA
Job Type full-time	Posted Mar 28, 2025

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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[Hiring] Revenue Cycle Specialist @Ems Management Consultants

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