Address Full Time
301B Route 1
Clerical/Administrative Support
Day Shift
MaineHealth is actively recruiting a Patient Financial Services Associate II to assist in the Ambulance Biller and Coder roles within the revenue cycle department. This is a 100% remote role.
* Responsible for billing ambulance claims to all third party payors
* Responsible for pre-billing claim edits
* Investigating and appealing insurance denials
* Validating contractual reimbursement on paid claims
* Follow up with insurance companies on unpaid, underpaid or denied claims.
* Reviewing patient care reports/run sheets.
* Selecting the proper diagnosis/condition codes
* Required- up to date CAC (Certified Ambulance Coder) certification.
Position Summary
This is the second level of a revenue cycle career path within PFS. Responsible for the specific set of patient accounting which could include the appropriate billing, training, and/or follow up/denial resolution of insurance claims within filing limits to support the proper account completion and closure prior to 120 days from the date of service. A trainer will ensure that the training and auditing needs of the department are met. Works within a team-based setting and ensures that workloads are distributed evenly. Responsible to perform the necessary account research required to determine proper governmental requirements prior to any claims' submission. Supports the overall success of Patient Financial Services by demonstrating flexibility, collaboration, and cooperation in a High Performance Work Team (HPWT) environment while maintaining a quality output and a high level of production. Continues to gain knowledge in all areas of Patient Financial Services to follow the MaineHealth growth path.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
* Education: High School graduate or GED preferred.
* License/Certifications: N/A
* Experience: 9 months in a related healthcare field. Hospital or Provider-Based billing experience is preferred.
* Able to work in a high volume, fast-paced work environment and perform and prioritize multiple tasks simultaneously.
* Proficiencies: Keyboard and data entry skills required. Computer experience is required with Microsoft Word and Excel, e-mail, and internet communication, as well as the ability to work effectively with electronic work quality monitoring and electronic systems.
* Requires the employee to have experience with, or the capability to be trained to solve problems and work towards solutions in an independent and/or team manner. For the trainer role, it requires the employee to have experience with, or the ability to be trained in auditing and training.
* Proven proficiency in working a minimum of one role (billing, collections, or healthcare accounts receivables training) for one payer (hospital) or one specialty (physician) or training.
* Specialized knowledge: Hospital or Provider-Based billing preferred.
* Working knowledge of CPT, HCPCS, ICD9/10 codes.
Remote/Hybrid
