*MUST RESIDE IN MESA, AZ* Falck is a is a global emergency medical services provider originating from Denmark that services 3 states in the US including: California, Oregon, and Colorado. Falck has been operating in the US since 2010 and is one of the largest private providers of emergency medical services in the country today. Our BLS and ALS services impact not only the lives of our patients, but their families and communities.
What We Offer: Full-Time Benefits (Medical, Dental, Vision, Life) 401(k) with company match Training and Career Development Paid Time-Off Pay Rate: $19.75-$23.00 per hour DOE
Position Summary:
The Postbill Specialist is responsible for timely follow up on insurance claims to facilitate payment from the appropriate source in a timely manner. The Postbill representative should be knowledgeable in all aspects of the life cycle of a claim, as well as the specific requirements of a variety of payors. Duties for this position are outlined below.
Essential Functions:
The Postbill Specialist must be able to adequately perform essential duties in an organized and efficient manner for all phases of the Postbill Department. These duties may include, but are not limited to the following:
•Follow-up on all assigned accounts from within the Billing systems in accordance with established goals to ensure timely collections.
•Sorts and responds timely and accurately to all incoming insurance correspondence and inquiries.
•Responds to all phone calls, emails, and other correspondence in an efficient and courteous manner.
•Prepares correspondence to payor as necessary.
•Utilizes Waystar, Payor Portals, and/or other methods of insurance verification as appropriate.
•Research calls/accounts and determine the nature of any problem in payment when required.
•Research and analyzes accounts and payments; reverses balances to credit or debit if charges were improperly billed or if payments were incorrect.
•Recognizes, verifies, and completes refund and offset requests as appropriate.
•Ensures that all conditions for payment receipt have been satisfied, which includes, but is not limited to, accurate charges and payor categorization; authorization/certification/TAR information; claims address; ICD-10 and HCPCS coding; patient insurance eligibility, patient benefit coverage; patient responsibility.
•Evaluates accounts to determine if any write-offs or claim corrections are required, including duplicate charges.
•Submits claims for secondary payment, as appropriate.
•Documents appropriate comments/notes in Billing System for every call, including any action taken.
•Thoroughly works Workflows, Claims Spreadsheets, and Aging reports as directed by management.
•Confirms claim status by phone, email, or online.
•Knows when to file appeals and ensures all appeals are completed accurately and timely.
•Recognizes and posts denials when needed.
•Reviews, sorts, and works payor correspondence accordingly.
•Research payor specific information, online, in provider manuals, and by calling payors.
•Reviews claims for accuracy must have a basic understanding of all other department functions (i.e. signature rules, ICD-10 coding, modifiers, etc.).
•Complies with all documented SOPs, compliance guidelines, and HIPAA regulations.
•Other duties as assigned by Postbill Management.
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. The individual in this position must possess the following qualifications.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
•This position is based out of the Mesa office. Remote may be available at Management's discretion.
•Must be proficient with Microsoft Suite (Excel, Word, PowerPoint).
•Working knowledge of KPI's/performance measures and the impact of revenue cycle on them.
•Excellent analytical skills and quality orientation-strives for continuous improvement in all activities to consistently achieve excellent results and meet or exceed department expectations.
•Must have knowledge of medical terminology.
•Must have willingness to work a flexible schedule.
•Overall leadership skills, including relationship building and fostering excellent achievement through teamwork.
•Must be self-starter with strong individual motivational skills.
•Strong interpersonal and communication skills with an ability to work effectively with a diverse range of individuals, from field teams to management, as well as external customers.
•Excellent ability to communicate and work cohesively across Department lines.
•Highly dependable and able to meet internal deadlines and quotas consistently.
•Flexible and adaptable, willing and able to adjust to rapidly changing priorities in a growing company.
•Must always maintain a professional demeanor and appearance.
Education Requirements:
The individual in this position must possess the following education requirements: Highschool diploma or GED Preferred Education: NAAC CAC Certification
Falck is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to race, color, religion, sex, gender identity, pregnancy, national origin, ancestry, citizenship, age, marital status, disability, sexual orientation, genetic information, veteran status or any other characteristic protected by state or federal law.
This job description is a summary of duties, it is by no means an all-inclusive list but is merely a broad guide of expected duties.
