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.
Reporting to the Patient Accounts Supervisor and Lead, individual will be responsible for follow up on Medicaid/AHCCCS, Medicare, Commercial Insurance and Contracted claims directly with the payers.
Administration / Quality Assurance:
Develop, control and prepare appropriate CQI reports ensuring timeliness, accuracy and completeness.
Track all aspects of missing PCRs, PCSs and determines appropriate processing.
Send daily reports of missing EPCRs to the Operations.
Prepare “as needed” reports for management using PCR, PCS data.
Monitor patient demographics of EPCR.
Report findings of trends and developments.
Tracking medical necessity fields on EPCR/CHOB STAT; missing medical necessity and additional paperwork.
Track and Analyze the Medical Necessity fields on EPCRs.
Troubleshoot problem areas as identified on reports.
Work with department manager to determine special projects on an as needed basis.
Participate in documentation feedback information for the operations.
Obtain continuous knowledge of CQI reporting.
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
Effectively work through denial/appeal process and meeting filing requirements
Attend and maintain all required R/M training
The ability to provide service and quality communications exhibiting a professional attitude at all times.
Ability to read, write and speak English in an easily understood manner.
Ability to type 40-50 wpm.
Strong medical terminology background.
Proficient in Microsoft Office, specifically Excel including the use of formulas and standard applications.
Demonstrated ability to properly combine analytical thinking with “big picture” planning.
Excellent organizational and communication skills.
Preferred Bachelors degree (B.A. or B.S.) from a four year college or university, or combination of education and previous experience.
Rural/Metro is a proud Equal Opportunity employer, m/f/d/v.
Rural/Metro Corporation - 2 years ago