Medical Billing Technician

Graduation from high school or equivalent and two years medical office with customer service experience; or any equivalent combination of related training and experience. College course work will substitute for experience on a year for year basis. Successful completion of a criminal history background investigation is required prior to employment. Applicants within six months of meeting the minimum education/experience requirement may be considered for trainee status.

 Position Summary: This is responsible clerical and record keeping work involving the application of medical terminology, and/or payment remittance principles for the establishment of medical and/or billing records within the Ambulance Billing Section of the Alachua County Department of Fire Rescue.

This is an emergency essential classification. Upon declaration of a disaster and/or emergency, all employees in this classification are required to work.

An employee assigned to this classification maintains records involving a variety of complex medical treatments administered during Emergency Medical responses throughout the county. Work is performed in accordance with clearly established methods and procedures established by the department to comply with external mandates that govern compliance for Medicare, Medicaid, Commercial Insurance and other requirements for EMS billing.

 

Work is performed under the direction of a higher level supervisor and is reviewed through conferences, reports, and observation of results obtained.

Exudes a positive customer service focus.

 

Advocates building organizational culture through aligning decisions with core values including: integrity, honesty, respect, diversity, innovation, accountability and communication.

Reviews and interprets Emergency Medical Service (EMS) reports for the input of billing and complete medical information utilizing EMS Billing and Collections Software.

Enters charges based on procedures outlined in the County Fee Schedule and the Centers for Medicare & Medicaid Services (CMS) Conditions List.

Reviews and interprets paper and electronic remittance notices to record payments to the billing database, and must apply various billing rules and procedures, based on the payer type, for payments received from patients, Medicare, Medicaid, commercial insurance companies and various other payers.

  

Assigns proper medical codes defined in the ICD-10 coding manual based on the medical narrative and enters the information according to the different needs of the various insurance carriers including Medicare, Medicaid, etc.

 

Verifies insurance coverage, computes benefits, and compiles itemized bills. Prepares insurance assignment form with data, such as names of insurance company and policy holder, policy number, and treatment provided.

Compiles medical records and account history information in response to inquiries from law firms, insurance companies, and government agencies, healthcare agencies, law enforcement agencies and patients.

Telephones, writes, or electronically communicates with insurance company to verify coverage and to obtain information concerning extent of benefits. Computes total bill showing amounts to be paid by insurance company and by client/patient, using billing software and/or related database(s).

Answers citizen/patient questions regarding statements and insurance coverage. Telephones or writes companies with unpaid insurance claims to obtain settlement of claim. Prepares forms outlining expenses for governmental, welfare, and other agencies paying bill for specified user.

Assists with scheduling non-emergent ambulance transports of patients and verifying payment prior to the time of transport.

Performs the duties listed, as well as those assigned, with professionalism and a sense of urgency.

NOTE: These examples are intended only as illustrations of the various kinds of work performed in positions allocated to this class. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position.

KNOWLEDGE, SKILLS AND ABILITIES

 

Thorough knowledge of EMS call reports and procedures.

Thorough knowledge and ability to properly assign ICD-10 codes based on content of EMS call reports.

Some knowledge of accounting principles and procedures and ability to apply such knowledge to billing transactions.

Knowledge of office methods and procedures and familiarity with the use of standard office equipment.

Ability to acquire knowledge of the laws, rules and regulations relative to ambulance billing and medical records. This includes knowledge of Medicare and Medicaid as well as other governmental and private insurance company requirements.

Ability to apply critical thinking in the course of maintaining records involving a variety of medical treatments administered during Emergency Medical responses.

Ability to perform daily work involving written or computerized data and to make entries rapidly and accurately.

Ability to understand and follow oral and written instructions from multiple references, sometimes for the same task.

 

Ability to type from clear or rough draft at a reasonable rate of speed.

Ability to establish and maintain effective working relationship with co-workers in close proximity and with frequent oral communications.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit for extended periods of time; talk or hear. The employee is occasionally required to reach and be mobile.

The employee must occasionally lift and/or move up to 10 pounds in the process of reviewing and/or filing of call reports. Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus associated with the constant use of a computer monitor.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate, including frequent oral communications between coworkers in a close working environment.