Repetitive Jobs (NOW HIRING)

Job Description:
The Repetitive Patient Coordinator is responsible for obtaining prior authorizations for repetitive and non-emergency
ambulance transports. This position requires strict adherence to the regulations regarding repetitive patients and
ensuring that we have secured the required documentation to facilitate reimbursement and compliance with
governmental regulations.
Essential Duties and Responsibilities:
• Check eligibility and benefits verification
• Contacting nursing home, physicians, patients, and various other facilities to secure PCS forms
• Develop strong relationships with healthcare partners in the communities we serve
• Maintain the patient activity log for all repetitive patients on the shared drive
• Coordinate with Dispatch to ensure timely feedback of transports that do not meet medical necessity
requirements for governmental payers
• Escalate any areas of non-compliance to PMBS Repetitive Patient Team Leadership
• Schedule claims for billing using billing software
• Following up on unpaid claims within standard billing cycle timeframe
• Processing incoming mail and taking appropriate follow up actions to resolve accounts
• Researching and appealing denied claims
• Answer telephone inquiries from the patient or insurance companies
• Contacting the patient to escalate issues regarding their ambulance transports
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
• Performing other duties as assigned.
Qualifications:
• Proficient with a PC
• Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
• Knowledge of procedure and diagnostic codes (HCPCS and ICD-10 codes)
• Knowledge of medical terminology
• Knowledge of Medical Billing
• Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and commercial payers
• Customer service skills for interacting with patients regarding medical claims and payments, including
communicating with patients and family members of diverse ages and backgrounds.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections
• Ability to work independently and with a group
• Working knowledge of MS Word, Excel
• Ability to maintain effective working relationships.
• Thorough knowledge of office practice
• Ability to type at least 35 words per minute.
• Proficiency using 10 key
Education and Experience Requirements:
• High School Diploma or GED
• Must have excellent verbal and written communication skills. Requires effective customer relation skills, ability to
organize and interpret data.
• Minimum of three year revenue cycle management experience or related clinical experience preferred.
• Experience working with MDS documentation or nursing home related experience.
• Medical Assistant or Licensed Practical Nurse preferred with knowledge of prior authorization and medical
necessity.
Physical Requirements:
• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other
federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
• Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local
standards.
• The employee may occasionally be required to lift and/or move up to 20 pounds.
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision,
depth perception, and the ability to adjust focus.
• Work may require sitting, lifting, stooping, bending, stretching, walking, standing, pushing, pulling, reaching, and
other physical exertion.
• Must be able to talk, listen and speak clearly on telephone.
• Must possess visual acuity to prepare and analyze data and figures, operate a computer terminal, and operate a
motor vehicle.
Travel Time: Negligible
NOTE: The above statements are intended to describe the general nature and level of work being performed by the
person assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, skills and
physical demands required of personnel so classified.