Billing Resolution Specialist I - Digitech - Remote
Sarnova
Sarnova
Summary: The Billing Resolution Specialist (BRSI) plays a critical role in Digitech’s RCM process by ensuring claims are coded and billed accurately and in a timely manner. The BRSI must maintain a strong working knowledge of billing rules and regulations for all payor types across the various regions in which they process claims. This role requires strong attention to detail and a commitment to the highest quality standards. The BRSI is primarily focused on resolving any issues that prevent a claim from being released to the appropriate payor. Maintaining the highest billing standards is essential to Digitech achieving its overall quality goals and vision: to be the trusted partner of choice that 100% of our clients would recommend to a friend or colleague.
Essential Duties and Responsibilities: • Perform post-billing review for eligible/valid patient or other applicable signatures to release claims for payment • Conduct post-billing review for third-party liability coverage • Review hospice-related claims to determine the appropriate payor • Review insurance information captured after initial billing to determine the correct payor • Submit new and corrected claims through online payor portals • Perform quality assurance reviews of claims processed by other segments • Attend and actively participate in team huddles and other required meetings • Consistently meet or exceed production goals while maintaining high-quality work • Provide timely feedback to leadership based on tasks worked • Maintain a high level of compliance with all regulatory requirements and internal policies and procedures • Adhere to all Digitech HIPAA privacy policies and procedures. This includes always maintaining the confidentiality and security of sensitive patient information • Additional job duties as assigned
Skills/Experience Required: • Education: High School Diploma or equivalent • 3+ years EMS Billing preferred • Certified Ambulance Coder (CAC) preferred • Demonstrated ability or willingness to attain QMC Biller Certification upon employment • Highly detailed-oriented • Proficient in Excel functions such as filters, pivot tables, and conditional formatting • Strong working knowledge of EMS billing rules and regulations, and a clear understanding of health insurance payor groups (Medicare, Medicaid, Commercial) • Ability to identify problems and escalate issues appropriately to leadership • Ability to quickly adapt to, learn, and retain changing client, payor, state, and MAC region rules and specifications • Quality-focused and process-driven • Excellent problem-solving skills • Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment
Sarnova is an Equal Opportunity Employer. We offer a competitive salary, commensurate with experience, along with a comprehensive benefits package, including 401(k) Plan. EO/M/F/Veterans/Disabled. Our mission is to be the best partner for those who save and improve patients’ lives. Excellence in delivering upon our mission is dependent upon having a diverse team that is empowered to bring their full, authentic self to work each day. We strive to create a workplace that reflects the communities we serve, and we are passionate about creating an inclusive workplace that promotes and values diversity.
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