BQA Patient Account Rep
Rural/Metro Corporation - Tucson, AZ

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From coast to coast, Rural/Metro employees are tied together by their overwhelming desire to help others. Every day and every call for our team of highly-trained professionals is different than the one before.

At Rural/Metro, we celebrate the successes of our team members, and doing the right thing for those we serve.

Rural/Metro is a leader in private ambulance and fire protection services in 21 states and more than 700 communities nationwide. Rural/Metro has provided high-quality patient care, met and exceeded the expectations of the communities we serve, and invested in the success of our employees since 1948.

Overview:

Reporting to the Patient Accounts Supervisor and Lead, individual will be responsible for the assistance in the areas of check-in, registration of patients, scanning and invoicing of all Patient Care Records.

Responsibilities:

Administration/Quality Assurance
  • Receipt and processing of Patient Care Reports (PCR's)
  • Review of PCR's to compile data
  • Assist customer service in an efficient and helpful manner
  • File or retrieve reports and records as needed
  • Determines whether a Physician Certificate Statement (PCS) is needed and received, if applicable
  • Track all aspects of missing PCRs, PCSs and determines appropriate processing
  • Reconciliation of PCR and transport numbers on a daily and monthly basis
  • Respond to requests for information
  • Make decisions and take appropriate actions based on sound reasoning and judgment.
  • Contribute ideas; strive to enhance team effectiveness and support decisions made by the team.
  • Plan and perform work systematically and efficiently.
  • Carry out instructions, maintain a positive attitude, and support company policies/procedures.
  • Punctuality and availability for workload.
  • Comply with HIPAA guidelines
  • Attend and maintain all required R/M training
  • Gather & scan supporting documents
  • Obtain prior authorization process
  • Review PCR’s for completeness & return to crew/ops for addendums as needed
  • Contacts hospitals and requests updated face sheets for PCRs that lack complete patient information.
  • Work with hospital liaisons and facility staff to obtain Physician Certification Statements (PCSs) for transports.
  • Complete and submit Treatment Authorization Requests for medical patients obtaining all required documentation. Respond to requests for additional information, appeal denials. (This is applicable for California only)
  • Sends invoices and follows up with contract payers for claims not covered under capitated contracts.
Customer Service
  • The ability to provide service and quality communications exhibiting a professional attitude at all times.
Compliance:
  • Reviews paperwork for accuracy and correct process.
  • Must participate in scheduled and unscheduled onsite compliance audits.
  • Implements corrective/preventive measures as determined by the Corporate Compliance/Audit Committee.
  • Cooperates with Internal Audit, Compliance and HR on any recommendations and changes to compliance and legal workflow issues.
  • Takes swift and immediate action in accordance with Internal Audit and Corporate Compliance on any areas of concern.
    • Complies and enforces all policies and procedures.
    • Has successfully completed all required Compliance Training within the required time period.
    • Has had no compliance related corrective action during the current review period.
Additional Duties:
  • All other duties as assigned or administered

Qualifications:
  • Ability to read, write and speak English in an easily understood manner.
  • Ability to type 40-50 wpm
  • Strong medical terminology background, CPT, ICDP coding
  • Knowledge of HCFA 1500 forms and Medicare guidelines are essential for completion of the data entry process.
Education Requirements:
  • High school diploma or GED
Rural/Metro is a proud Equal Opportunity employer, m/f/d/v.

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