[Hiring] Prebill Specialist I @Sarnova

Role Description

The Prebill Specialist I (PBSI) plays a key role in Digitech’s RCM process by accurately and efficiently verifying prebill information—including patient demographics, payor details, and transport modifiers—before coding. The PBSI ensures all required information is thoroughly reviewed and correctly entered on each transport claim prior to coding. This role is essential to upholding Digitech’s quality standards and supporting our vision of being the trusted partner of choice that 100% of our clients would recommend to a friend or colleague.

• Utilize preferred system tools (hospital registration system, face sheet, HL7 feed, etc.) to locate insurance and patient demographic information.
• Place claims in the Insurance Discovery workflow when no insurance is found.
• Accurately enter patient demographics.
• Follow the Master Billing Guide instructions to select the appropriate modifiers and payors for the transport.
• Follow the SOPs to select the appropriate modifiers, tags, and payors.
• If required, call facility payor (SNF, Assisted Living, Hospice) to confirm appropriate transport modifiers.
• Participate in Prebill Huddles to review and align on processes.
• Upon verifying patient, payor, and modifier information, place the claim in the appropriate tag for the next step.
• Consistently achieve or exceed the Prebill Specialist’s daily production and quality goals.
• Adhere to all Digitech HIPAA privacy policies and procedures, maintaining the confidentiality and security of sensitive patient information.
• Additional job duties as assigned.

Qualifications

• High School Diploma or equivalent.
• 1+ year of revenue cycle management experience preferred.
• Ability to identify problems and escalate issues appropriately to Prebill Lead.
• Motivated self-starter, independent thinker capable of working both independently and within a collaborative team environment.
• RCM experience preferred.
• Working knowledge of health insurance verification and basic understanding of major payor groups (Medicare, Medicaid, Commercial), preferred.
• Ability to learn and maintain a growing knowledge of various state regulations and payor guidelines.
• Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment.

Benefits

• Competitive salary, commensurate with experience.
• Comprehensive benefits package, including 401(k) Plan.