Ambulance Authorization and Billing Specialist in Largo, Florida at Paramedics Logistics Florida (Sunstar Paramedics)

Paramedics Logistics Florida (Sunstar Paramedics)

Location: Largo, FL

Department: Administrative Offices
FLSA Status: Non-Exempt
Summary:

This position may be located in the Communications Center and helps to ensure compliance with the Pinellas County Ambulance Service Agreement, local, state, and governmental agencies. This position is responsible for the accurate and timely collection of patient billing information and securing insurance pre-authorizations and required forms for interfacility ambulance transport requests. This position will interact throughout the company internally and with various entities externally.

Major Duties and Responsibilities:

• Assist in processing incoming interfacility ambulance transport requests via phone, fax, or electronic systems to ensure they have the necessary information to be billable.
• Ensure transports meet medical necessity guidelines and payer requirements for coverage.
• Maintain and update list of payor requirements regarding pre-authorization.
• Communicate with healthcare facilities to clarify payer requirements and obtain prior authorization when required.
• Accurately document authorization numbers, payer details, and any communication in the dispatch and billing systems.
• Assist in auditing PCS forms/correcting and or calling to have forms corrected.
• Ensuring PCS form and billing information and authorization is gathered on call prior to being released for service.
• Provide assistance to obtain the 60 Day PCS Forms required on repetitive patients.
• Maintain confidentiality and compliance with HIPAA and all applicable regulations.

Other Duties and Responsibilities:

• Monitoring Open Work queue.
• Answer questions from call takers regarding transports and forms.
• Monitoring fax folder for PCS Forms when needed.
• Fax forms to Dr's for patients coming out of private residences.
• Assist call takers with any needs they may have regarding specialty calls.

Minimum Qualifications:

• High school diploma or equivalent
• Medical billing / Insurance pre-authorization experience
• Prior insurance/Medicaid billing experience; extensive computer skills

Preferred Qualifications:

• College degree

Physical Requirements:

• Occasionally: Bending, leaning
• Frequently: Hearing/listening, clear speech, touching, typing
• Constantly: Sitting, seeing

All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or other legally protected status.