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City of Austin - JOB DESCRIPTION

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Ambulance Billing and Coding Representative II


FLSA: Standard/Non-Exempt EEO Category: (60) Admin/Supp
Class Code: 13385 Salary Grade: YE2
Approved: September 25, 2015 Last Revised: August 11, 2022


Purpose:
 

Under limited supervision, using independent discretion and judgement, this position performs advanced-level ambulance billing, recordkeeping, and accounting tasks related to the recovery of revenue for all billable services provided by Austin-Travis County EMS. 

Duties, Functions and Responsibilities:
  Essential duties and functions, pursuant to the Americans with Disabilities Act, may include the following. Other related duties may be assigned.
  1. Receives and resolves escalated customer service calls from the public, third-party payers, and insurance carriers.
  2. Delivers training and provides guidance to new and tenured billing and coding employees.
  3. Assists with creating procedures to enhance the billing process.
  4. Reviews information to determine patterns or discrepancies to improve billing processes.
  5. Reviews work for quality assurance and claim verification.
  6. Reviews hardship billing cases and contacts clients for special payment arrangements.
  7. Troubleshoots process and technical issues related to day-to-day operations.
  8. Develops and submits daily, weekly, monthly, and quarterly reports.
Responsibilities - Supervisor and/or Leadership Exercised:
 

May provide leadership, work assignments, evaluation, training, and guidance to others.

Knowledge, Skills, and Abilities:
  Must possess required knowledge, skills, abilities, and experience and be able to explain and demonstrate, with or without reasonable accommodations, that the essential functions of the job can be performed.
  • Knowledge of medical, insurance, and healthcare terminology and industry regulations and requirements.
  • Knowledge of complicated multi-system medical terminology and general anatomy.
  • Knowledge of medical conditions/signs and symptomology.
  • Knowledge of Local, State, and Federal laws including HIPAA; and Medicare, Medicaid, and other public health plans.
  • Knowledge of coding audits and Federal, State, and Local rules and regulations regarding medical claims.
  • Knowledge of accounting and bookkeeping practices and concepts, as well as cash handling and account collections procedures and practices.
  • Knowledge of signature requirements.
  • Skill in medical coding.
  • Skill in insurance verification.
  • Skill in establishing and maintaining good working relationships with internal and external customers.
  • Skill in handling multiple tasks and prioritizing.
  • Skill in using computers and related software, multiple phone line systems, and credit card machines.
  • Skill in using Microsoft software programs.
  • Skill in effective oral and/or written communication.
  • Skill in reviewing (proofreading) material to ensure accuracy, completeness, and adherence to established formats.
  • Skill in interpreting and analyzing applicable data.
  • Skill to provide on-the-job training and guidance.
  • Ability to provide exceptional customer service.
  • Ability to understand and communicate technical information.
  • Ability to compile data for use in reports, review database records, understand and carry out basic claims procedures.
  • Ability to exercise discretion in confidential matters.
  • Ability to establish and maintain effective working relationships with City employees and the public.
  • Ability to work under pressure with frequent interruptions and changes in priorities.
  • Ability to manage conflicts and concerns and work with difficult customers.
  • Ability to work in a call center type environment.
  • Ability to recognize valid versus invalid signature types.
Minimum Qualifications:
 

Graduation from an accredited high school or equivalent, plus four (4) years of experience with medical terminology, medical insurance, and medical billing and coding principles and practices.

Licenses and Certifications Required:
  None.

This description is intended to indicate the kinds of tasks and levels of work difficulty required of the position given this title and shall not be construed as declaring what the specific duties and responsibilities of any particular position shall be. It is not intended to limit or in any way modify the right of management to assign, direct and control the work of employees under supervision. The listing of duties and responsibilities shall not be held to exclude other duties not mentioned that are of similar kind or level of difficulty.