EMS Revenue Specialist 

The EMS Revenue Specialist is responsible for working directly with the Health Insurance Companies to resolve open balances.  This could include but not limited: utilizing payer portals to check claim status, updating patients’ insurance policy, reviewing / updating the ICD-10 code listed, sending corrected claims and/or appeals.  

All representatives will conduct insurance verification as needed and are required to complete prebilling training to qualify for the role.  

Responsibilities of the EMS Revenue Specialist 

• Places and receives calls regarding billing insurance questions and other patient service activities.  

• Process accounts according to the action required to resolve account balances. 

• Resolving insurance carrier denials, appealing claims, contacting carriers on open accounts, and responding to insurance carrier correspondence and/or inquiries. 

• Comfortable communicating with any caller including customers, agencies, facilities, and hospitals. 

• Employ one-step resolution practices for clients and patients through open lines of communication. 

• Research patient accounts to verify all health insurance coverages. Audit patient accounts to verify proper billing process was followed. 

• Compute adjustments based on EOB's remittance and insurance contracts. 

• Ensure accuracy in data entry and consistent attention to detail. 

• Collect outstanding balances as well as identify, address, and resolve account discrepancies while following company policy and procedures. 

• Demonstrates knowledge and compliance of insurance, local, state, and federal billing. 

• Ability to complete tasks efficiently both individually and in a group environment. 

• Handle assigned correspondence fulfilling any other duties as assigned by managerial staff. 

Key Skills of the EMS Revenue Specialist  

• Well-versed with medical billing practices that include an understanding of insurance billing codes, regulations, and procedures.  

• Ability to investigate and resolve software issues, billing errors and disputes.   

• Effective communication skills with clients, insurance companies, patients, staff members and management.   

• Ability to manage multiple tasks and meet deadlines.  

• Must have great attention to detail with high accuracy.  

Qualifications of the EMS Revenue Specialist 

• College preferred but not required. 

• Minimum two years’ experience in customer care, account management or similar role. 

• Ability to read and understand the Explanation of Benefits or Electronic Remittance Advice. 

• Understands the difference between rejections and denials as well as working accounts. 

• Healthcare knowledge is preferred. 

• Must be a quick learner and motivated individual with excellent verbal communications skills. 

• Ability to “multi-task” and manage spurs of high call volume / stress. 

• Positive, can-do attitude and with good judgement demonstrating ability to escalate account when needed. 

• Ability to receive and implement feedback. 

Computer and Office Qualifications of the EMS Revenue Specialist 

• Computer literacy is a must;  Typing skillset of at least 45 WPM is highly desired 

• Experience working in an active office environment. 

• Must be able to work with 2 monitors and split screens to operate multiple sites simultaneously. 

• Must be able to sit / stand for 8 hours minimum in an office environment 

• Must be able to use Word, Excel Spreadsheet, Email, Chat Applications, and other software applications. 

• Must be able to read, comprehend, and apply job-related rules, policies, and procedures.