Transport Billing Specialist

About the Job

Location: NHRMC Orthopedic Hospital

Department: Mobile Integrated Health

Full Time Equivalent: Fulltime

Work Type: 64 to 80 Hours Pay Period

Work Schedule: 8HR DAY - 8am to 5pm

Exempt from Overtime: Exempt: No

What You'll Do

Summary:

Under the general direction of the Business Manager, this specialist is responsible for accurately processing, coding, and data entry for all Emergency Services ambulance transports, treat and release, and refusals. Performs medical record review of each patient record for reasonableness and necessity of ambulance service as well as for demographic information, mileage, etc. Ensures presence and completeness of necessary forms. Works with NHRMC staff and outside customers to obtain any necessary clarification or documentation. This person requires little supervision and performs all work independently, with a high degree of autonomy. All work is carried out in accordance with the department’s approved policies and procedures. This position is an advanced level technical position within Emergency Services.

Responsibilities:

1. Responsible for maintaining knowledge of all current federal and state rules, regulations and guidelines related to ambulance billing. 2. Ensures that all VitaLink, AirLink and PCTS charts are accounted for by cross-checking list of patients in EMS Charts with list generated by the CAD. Ensures EMS charts are accounted for by making sure all charts from EMS charts are coded and keyed. 3. Insures that all required documentation for billing purposes is present before billing ambulance service. 4. Ensures all forms, including the PCS, ABN and AOB are obtained and complete, as needed. 5. Codes and post charges for all transports, treatment and release, and refusals in accordance with provisions of all governmental and private Third Party rules and regulations. 6. Works with HIM to assign medical record numbers and create patient accounts for refusal patients. 7. Abstracts patient information from records and enters appropriate data elements into the computerized abstracting systems (Series).The minimum coding requirement is to have all ambulance transports posted within 3 business days. The desired is to have 90% of all postings completed within 1 business day from the date of service. If the transport cannot be coded and posted within 3 business days of service, PFS must be notified so that the bill is temporarily held. 8. Ensures all codes and charges are processed accurately. Responsible for maintaining departmental compliance audit scores at passing level. 9. Performs charge reconciliation daily. 10. Collaborates with direct patient care professionals regarding documentation that supports need for ambulance service, etc. according to CMS and departmental guidelines. 11. Collaborates with Regional Communications, Case Management, Compliance and other applicable areas as needed. 12. Attends monthly EMS, PCTS, VitaLink/AirLink staff meetings to educate crew on documentation issues, changes in CMS regulations and to field any questions from the staff. Gives in-services as needed or as requested by manager/staff. 13. Fosters respect for patient privacy by maintaining strict confidentiality in all phases of work.

Position Requirements

Credentials:

Education:
Essential:
* High School Diploma

Other information:

Experience: One year ambulance coding as well as experience in EMS electronic charting, IBAX (Series) Windows 2000, Word and Excel preferred. In-depth knowledge of EMS patient care report content and appropriate sequence of actions required. Demonstrates standards of performance (ownership, teamwork, communication, compassion) that support patient satisfaction and principles of service excellence. Performs other duties as assigned. Individual will possess commensurate combination of education, experience and qualifications.

Other Information

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