Falck is a is a global emergency medical services provider originating from Denmark that services 4 states in the US including: California, Washington, Oregon, and Colorado. Falck has been operating in the US since 2010 and is one of the largest private providers of emergency medical services in the country today. Our BLS and ALS services impact not only the lives of our patients, but their families and communities.

Position Summary:

The Postbill Specialist is responsible for timely follow up on insurance claims after the initial sent claim in order to facilitate payment from the appropriate source in a timely manner. Duties for this position are outlined below. The Postbill representative should be knowledgeable in the life-cycle of a claim and the expectation of a variety of payors.

Essential Functions:

The Postbill Specialist must be able to adequately perform essential duties in an organized and efficient manner for all phases of the Postbill Department. These duties may include, but not limited to the following:

• Follows-up on all assigned accounts from within the Billing systems in accordance with pre-established goals to ensure timely collections.
• Sorts and responds timely and accurately to all incoming insurance correspondence and inquiries.
• Responds to all phone calls from other departments or insurance companies in an efficient and courteous manner.
• Prepares correspondence to payer as necessary.
• Utilize Passport and/or other methods of insurance verification as appropriate.
• Research calls/accounts and determine the nature of any problem in payment on the account when required.
• Researches and analyzes accounts and payments; reverses balances to credit or debit if charges were improperly billed or if payments were incorrect.
• Ensures that all conditions for payment receipt have been satisfied, which includes, but is not limited to, accurate charges and payor category; authorization/certification/TAR information; claims address; ICD10 and HCPCS coding; patient insurance eligibility, patient benefit coverage; patient responsibility.
• Evaluates accounts to determine any write-offs or corrections required, including duplicate charges.
• Submits claims for secondary payment, as appropriate.
• Documents appropriate comments/notes in Billing System for every call, including any action taken.
• Thoroughly work Aging reports as directed by management.
• Claim status by phone or online.
• Know when to file appeal and ensure all appeals are timely.
• Recognize and post denials when needed.
• Review/work payor correspondence accordingly.
• Research payor specific information, online, in provider manuals, and by calling payors.
• Review claim for accuracy (as needed), must have a basic understanding of the Prebill functions (i.e. signature rules, ICD-10 coding, modifiers, etc.).
• Other duties as assigned by Postbill Management.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. The individual in this position must possess the following qualifications:

• This position is based out of the Mesa office. Remote may be available at Management’s discretion.
• Must be proficient with Microsoft Suite (Excel, Word, PowerPoint).
• Working knowledge of KPI’s/performance measures and the impact of revenue cycle on them.
• Excellent analytical skills and quality orientation-strives for continuous improvement in all activities to consistently achieve excellent results and meet or exceed department expectations.
• Must have knowledge of medical terminology.
• Must have willingness to work a flexible schedule.
• Overall leadership skills, including relationship building and fostering excellent achievement through teamwork.
• Must be self-starter with strong individual motivational skills.
• Strong interpersonal and communication skills with an ability to work effectively with a diverse range of individuals, from field teams to management, as well as external customers.
• Excellent ability to communicate and work cohesively across Department lines.
• Highly dependable and able to meet internal deadlines consistently.
• Flexible and adaptable, willing and able to adjust to rapidly changing priorities in a growing company.
• Must always maintain a professional demeanor and appearance.

Education Requirements:

The individual in this position must possess the following education requirements:

• High school diploma or general education degree (GED)

Physical Requirements:

While performing the duties of this job, the employee is regularly required to stand; walk; sit; use hands to feel objects, tools, or controls; reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl; speak, hear, and smell. Specific vision abilities required by this job include close and distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Must also have the ability to lift, carry up to 15 pounds.

Cognitive/Psychosocial Requirements:

The mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:

• Memorization, critical judgment, perception/computation, problem solving, analytical skills, ethical judgment and reasoning, logic, active listening skills, strategic decision making, ability to communicate effectively in written and verbal formats.

Equipment Operated:

The individual in this position must be familiar with using the following equipment to perform the essential functions of this job:

• Computer, printer, scanner, cell phone

Falck is an equal opportunity employer and values diversity. All employment is decided on the basis of qualifications, merit and business need.