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PA- Review Appeal Specialist (RNA) at Air-Evac Lifeteam

Posted in Other 30+ days ago.

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Type: Full Time
Location: West Plains, Missouri





Job Description:

OVERVIEW

Manages assigned accounts concerning Medicare/Medicaid/Insurances that do not meet the expected reimbursement rate. Recognizes and captures the opportunities for increased revenue through the appeals process with various payors. Determines the level of benefits payable for ambulance transport by the carrier that has rendered payment on patient account.

RESPONSIBILITIES

Information gathering

* Gathers information necessary to appeal the appropriate payor, determines that an account has been paid correctly so that the account can returned the original representative.

* Examines patient record and gathers appropriate information.

* Assists reimbursement department as needed.

* Requests hospital records to assist with appeal process.

Billing

* Bills the appropriate payer

* Monitors payments monthly concerning reviews and appeals process.

* Distributes monthly statements to patients advising of account status.

Management of Accounts

* Generates billing process, follows accounts, and makes necessary contacts with insurance payors or patients to assure maximum reimbursement.

* Submits necessary documentation to appropriate agency to ensure maximum reimbursement rate.

* Renders to the appropriate account representative when attempts are exhausted.

* Tracks and manages return of accounts.

* Communicates with patient in an attempt to obtain applicable authorizations for appeals.

QUALIFICATIONS

Education:

* High school diploma or equivalent

Skills:

* Organized

* Ability to use independent judgment and to manage and impart confidential information

* Ability to gather data, compile information, and prepare reports

* Ability to calculate numbers, correct entries, and post to records

Experience:

* One year experience in an office atmosphere with knowledge of medical billing collections.

An Equal Opportunity Employer: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

TIME TYPE (PORTAL SEARCHING)

Regular Full-Time