The Revenue Cycle Specialist II (RCS-II) will be responsible for a variety of claims management functions including but not limited to reading Patient Care Reports and Certificate of Medical Necessities to determine appropriate ICD-10 codes to be assigned as well as HCPCS Codes and Modifiers on Ambulance Transport Claims, to ensure clean submission and resolution of said claims. The RCS-II reports directly to the Accounts Receivable Manager and would be eligible for a hybrid remote work schedule at the completion of six months of successful employment.

Role and Responsibilities

Coding of Ambulance Claims (ICD-10, HCPCS, & Modifiers).
Prepare and submit claims to Medicare, Medicaid, private insurance, and self-pay patients.
Apply accurate modifiers (e.g., origin/destination, transport type).
Ensure proper use of ABNs (Advance Beneficiary Notices) when required.
Enter charges into billing systems accurately and timely.
Submit secondary and tertiary claims when applicable.
Return of Claims to Crews or Facilities for Corrections.
Manage inbound customer calls.
Verification tasks specific to payor type.
Researches all information to complete accurate billing processes including assignment of billing charge codes and ICD-10 diagnosis codes.
Maintain productivity and accuracy standards.
Adhere to all HIPAA regulations and compliance guidelines.
Demonstrate a strong commitment to workplace safety by identifying hazards, reporting risks, and supporting continuous safety improvements.
Adhere to all company safety policies, procedures, and regulatory requirements while actively promoting a safe and compliant work environment.
Collaborate with team members to uphold safety standards and foster a culture of safety across all operations.
Other duties as assigned.

Qualifications and Education Requirements

Must be at least 18 years old or older at time of hire
Graduation From High School or equivalent
Customer service experience
Ability to view computer monitor for extended periods (more than 8 hours)
Ability to remain composed and multi-task in a busy, high-pressure environment.
Ability to comprehend or learn department practices, rules, and regulations quickly.
Ability to operate telephone and other specialized computer communication equipment.
Ability to learn new software.
Ability to speak clearly, concisely, and respectfully.
Ability to communicate effectively with a diverse population, including medical professionals.
Ability to think and react quickly and effectively in tense situations.
Ability to follow written and oral instructions.
Ability to recall details from numerous informational resources.
Ability to prioritize decisions based upon multiple criteria and identifiable standards of policies and procedures.
Maintain a reliable attendance record and be punctual daily.
Pass background investigation
Pass a pre-employment drug screen and all subsequent random or for cause drug screenings.
Ability to lift up to 25 lbs.
Ability to speak, read, and write English

Preferred Skills

ICD-10 Coding and billing.
Knowledge of payor types – Medicare, Medicaid, private insurance
Proficiency in Microsoft Office Suite

We'd love to have you join the WLRC Medical Team!

#HP

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