Billing Resolution Specialist I - Digitech - Remote

About the Role

The role is part of a larger team that is responsible for managing the entire EMS revenue lifecycle, from claim submission to payment posting. The team's primary goal is to maximize collections, protect compliance, and deliver results for clients. To achieve this, the Billing Resolution Specialist I will be working closely with other team members to identify and resolve any issues that may prevent a claim from being released to the payor.

What You Will Do

• 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, including maintaining the confidentiality and security of sensitive patient information

What We Are Looking For

• High School Diploma or equivalent
• 3+ years of experience in EMS billing, preferably with a focus on revenue cycle management
• Certified Ambulance Coder (CAC) certification, or willingness to attain QMC Biller Certification upon employment
• 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, with excellent problem-solving skills

Nice to Have

• Experience working in a remote environment, with the ability to manage time effectively and work independently
• Knowledge of Digitech's proprietary technology and software platform
• Familiarity with online payor portals and claims submission processes

Benefits and Perks

• Competitive salary, commensurate with experience
• Comprehensive benefits package, including 401(k) Plan
• Opportunity to work with a leading provider of advanced billing and technology services
• Remote work environment, with the flexibility to work from anywhere
• Professional development opportunities, including training and certification programs
• Collaborative and dynamic team environment, with a focus on quality and results

• Make sure to highlight your experience with Excel and billing software in your application, as these skills are essential for the role.
• Be prepared to provide specific examples of your problem-solving skills and ability to work in a fast-paced environment.
• Research Digitech's proprietary technology and software platform to demonstrate your knowledge and interest in the company.
• Emphasize your ability to work independently and manage your time effectively in a remote environment.
• Consider obtaining the Certified Ambulance Coder (CAC) certification or QMC Biller Certification to increase your chances of being selected for the role.
• Be prepared to ask questions about the company culture, team dynamics, and opportunities for growth and development during the interview process.