Billing Resolution Specialist - Digitech - Remote

About the role

The Billing Resolution Specialist (BRSI) plays a critical role in Digitech’s Revenue Cycle Management (RCM) process by ensuring claims are coded and billed accurately and in a timely manner. The role requires a strong working knowledge of billing rules and regulations for all payor types across various regions.

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
• 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

Requirements

• 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

Qualifications

• High School Diploma or equivalent
• 3+ years EMS Billing experience preferred
• Certified Ambulance Coder (CAC) preferred
• Ability to attain QMC Biller Certification upon employment
• Proficiency in Excel functions
• Strong knowledge of EMS billing rules and regulations
• Ability to identify and resolve billing issues
• Compliance with regulatory requirements and internal policies
• Confidentiality and security of sensitive patient information

Skills

• Excel functions: filters, pivot tables, conditional formatting
• Billing rules and regulations
• Health insurance payor groups (Medicare, Medicaid, Commercial)
• Problem identification and escalation
• Quality-focused and process-driven
• Problem-solving skills
• Independent management of job role

Benefits

Sarnova offers a competitive salary, commensurate with experience, along with a comprehensive benefits package, including a 401(k) Plan. We are an Equal Opportunity Employer and proud to foster a workplace environment that reflects the communities we serve. 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.