EMS Billing Audit & Compliance Specialist - EMS

Department : EMS

Pay : $23.27 per hour

Work Schedule : M-F 8-5

This position supports the Sedgwick County Emergency Medical Services by auditing completed reports by the billing team, and resolving escalated issues or special reporting requirements.

The Audit & Compliance Specialist reviews reports for certain payers and call types, and ensures all information is in compliance with all laws, regulations, and policies.

This position also processes urgent reports. This position works extensively with information protected under HIPAA. Moreover, the position is exposed to highly sensitive and potentially disturbing information related to emergency medicine and patient information, and requires a high level of discretion.

Billing Audit & Compliance

• Audit completed electronic patient care reports (EPCR) for accuracy and completeness as needed
• Regularly complete the Medicare Compliance Review, auditing 20% of Medicare-related reports that have gone through the billing stage
• Regularly track and complete the Facilities modifier roster to assist crews in filing reports
• On tickets with outdated information, verify and remove old or incorrect information related to patient demographics and insurance coverage

Report Processing

• Search for payment sources and call types in the ticketing system to identify tickets that need to be worked more urgently or with different procedures
• Evaluate self-pay reports flagged by the billing team, and run Accurint search to obtain additional demographic information needed
• Confirm patient age on self-pay reports to identify guarantor information when needed
• Complete Non-Emergent transfer reports within 72 hours, including the additional forms and information
• Assist the billing team with any escalated concerns, including processing complicated tickets and communication with crews

Interaction with Internal and External Partners

• Communicate with EMS crews to obtain information needed to complete non-emergent reports
• Communicate with the jail and other facilities for status information needed for billing
• Interact with partners involved with workers’ compensation-related calls
• Process VA related tickets and track payment information
• Answer questions for crews as needed by phone or in-person
• Follow up with crews to clarify other potential issues in reports, and update information as needed to maintain compliance with all laws, regulations, and policies

Minimum Qualifications : High school diploma or equivalent. One (1) year of experience or education in medical administration, billing, or related fields.

One year of experience with work that included auditing and compliance, mathematics, or a related field. One year of experience with Microsoft Suite or similar systems.

Must obtain Accurint certification within 90 days as department business allows.

Preferred Qualifications : Formal coursework in HealthCare billing. Formal coursework in Microsoft Suite or other applicable computer systems.

Two (2) years of experience in healthcare billing or insurance. Formal or informal leadership experience. Notary public.

It is the policy of Sedgwick County not to discriminate in its programs or services provided to the general public, including employment and all other activities, on the basis of race, color, religion, national origin, citizenship, sex, age, disability, veteran status or any other similarly protected status.

Sedgwick County is committed to making the application, interview, and pre-employment testing process accessible to persons with disabilities.

If you wish to volunteer information regarding any special assistance you may need, please notify Human Resources by phone at (316) 660-7050, TDD (Kansas Relay at 711 or 800-766-3777).

Do not use this phone number for employment questions. This number is provided only for those requiring ADA assistance. You will be contacted should the department feel that you are a qualified candidate.