The Revenue Cycle Specialist II (RCS-II) will be responsible for a variety of claims management functions including but not limited to reading Patient Care Reports and Certificate of Medical Necessities to determine appropriate ICD-10 codes to be assigned as well as HCPCS Codes and Modifiers on Ambulance Transport Claims, to ensure clean submission and resolution of said claims. The RCS-II reports directly to the Accounts Receivable Manager and would be eligible for a hybrid remote work schedule at the completion of six months of successful employment.
Role and Responsibilities
-
Coding of Ambulance Claims (ICD-10, HCPCS, & Modifiers).
-
Prepare and submit claims to Medicare, Medicaid, private insurance, and self-pay patients.
-
Apply accurate modifiers (e.g., origin/destination, transport type).
-
Ensure proper use of ABNs (Advance Beneficiary Notices) when required.
-
Enter charges into billing systems accurately and timely.
-
Submit secondary and tertiary claims when applicable.
-
Return of Claims to Crews or Facilities for Corrections.
-
Manage inbound customer calls.
-
Verification tasks specific to payor type.
-
Researches all information to complete accurate billing processes including assignment of billing charge codes and ICD-10 diagnosis codes.
-
Maintain productivity and accuracy standards.
-
Adhere to all HIPAA regulations and compliance guidelines.
-
Demonstrate a strong commitment to workplace safety by identifying hazards, reporting risks, and supporting continuous safety improvements.
-
Adhere to all company safety policies, procedures, and regulatory requirements while actively promoting a safe and compliant work environment.
-
Collaborate with team members to uphold safety standards and foster a culture of safety across all operations.
-
Other duties as assigned.
Qualifications and Education Requirements
-
Must be at least 18 years old or older at time of hire
-
Graduation From High School or equivalent
-
Customer service experience
-
Ability to view computer monitor for extended periods (more than 8 hours)
-
Ability to remain composed and multi-task in a busy, high-pressure environment.
-
Ability to comprehend or learn department practices, rules, and regulations quickly.
-
Ability to operate telephone and other specialized computer communication equipment.
-
Ability to learn new software.
-
Ability to speak clearly, concisely, and respectfully.
-
Ability to communicate effectively with a diverse population, including medical professionals.
-
Ability to think and react quickly and effectively in tense situations.
-
Ability to follow written and oral instructions.
-
Ability to recall details from numerous informational resources.
-
Ability to prioritize decisions based upon multiple criteria and identifiable standards of policies and procedures.
-
Maintain a reliable attendance record and be punctual daily.
-
Pass background investigation
-
Pass a pre-employment drug screen and all subsequent random or for cause drug screenings.
-
Ability to lift up to 25 lbs.
-
Ability to speak, read, and write English
Preferred Skills
-
ICD-10 Coding and billing.
-
Knowledge of payor types – Medicare, Medicaid, private insurance
-
Proficiency in Microsoft Office Suite
We'd love to have you join the WLRC Medical Team!
#HP
