LEAD AMBULANCE BILLING SPECIALIST

Recruitment #2001-0168-001

Introduction

 * * * THIS POSITION IS ONLY OPEN TO CURRENT CITY OF TUCSON PERMANENT AND PROBATIONARY EMPLOYEES * * *

To remain eligible, you must maintain your permanent or probationary Civil Service employment status through the actual date of transfer. If you are not a current permanent or probationary Civil Service employee at the date of transfer, you will not be eligible for this position. Non-permanent or appointed employees are not eligible.

The Eligibility List may be used by any City department with an approved vacancy to fill in the next 6 months. Selection will be made in accordance with CSR III, Section 2. The list of employees eligible for consideration will remain in effect for 6 months after their names are provided to the hiring authorities. Examination results and current status will be communicated by email.

General Description

This classification is a lead position affording guidance to Ambulance Billing Specialist I and II. This lead position also reviews workloads and assists with training and performance measures. This classification performs billing and audit of Advanced Life Support transport claims and necessary follow-up with Medicare, Medicaid, primary and secondary insurance companies, and private payers to ensure claim accuracy.

This classification will have broad knowledge of all federal and state regulations applying to each individual insurance carrier. Employees in this classification must be able to understand and apply appropriate ICD-10 codes, medical terminology and human anatomy for billing purposes. Employees in this classification must be able to demonstrate a complex understanding of Medicare and Medicaid regulations and the EMS practice management software.

Essential Functions

Verifies service details, including pick-up and drop-off addresses, date and time, call type, response priority and transport priority.

Verifies patient demographics, including name, address, date of birth, social security number, insurance information and eligibility, and updates as needed.

Ensures trip tickets received is equal to the total trips for that day by reviewing dispatch logs and patient care reports. Utilizes EMS practice management software to enter necessary claim details and patient information.

Reviews patient care reports and medical reports for medical necessity and to apply the appropriate service code, ICD-10 diagnosis code, condition code, and origin/destination modifier.

Initiates clean electronic or paper claims to the appropriate payer source to ensure timely reimbursement from payers and patients.

Communicates between patients and payers regarding the status of claims and to help resolve issues by providing requested information.

Performs complex claim corrections, appeals, and follow up activities with payers and patients.

Processes payments, downloads payment reports, processes electronic fund transfers, paper checks and credit cards.

Prepares and reconciles daily deposits.

Provides guidance and coaching to Ambulance Billing Specialists.

Assists in the development and monitoring of performance measures, training and procedures.

Audits medical claims for compliance with federal, state, and local regulations and policies.

Analyzes denial trends and makes necessary system changes to resolve them.

Reviews appropriate payer and government web sites and attends continuing education seminars in order to stay abreast of industry changes.

 

Minimum Qualifications

Minimum Education Level & Type: 6 months Post High School

Minimum Experience Qualifications: At least 3 years of experience in medical or ambulance billing and ICD coding

An equivalent combination of education, training, and experience which provides the required knowledge, skills, and abilities to perform the essential functions of this position may be considered.

Special Job Requirements

Certified Ambulance Coder (CAC), within 12 months of hire.

This position requires satisfactory criminal background and reference checks, and may require a Motor Vehicle History Report and Public Records Check. Employment offers are contingent upon successfully passing any of the above requirements.  In addition, the Fire Department will verify that an applicant's name does not appear on the Office of Inspector General's List of Excluded Individuals/Entities (OIG LEIE). This verification will be performed by the Fire Department upon hire and monthly thereafter. If an employee's name is found on such a list, the offer of employment will be rescinded.

Preferred Qualifications

Knowledge of Medicare / Medicaid regulations for state of Arizona.

Current or previous EMT Certification.

Ability to operate a 10-key calculator by touch.

Keyboarding skills of at least 35 WPM with a 90% accuracy.

 

Selection Plan

Applicants who meet the minimum qualifications will be evaluated on the education and work experience in their employment profile and the responses to their supplemental questions. The highest scoring applicants will then be invited to participate in an Panel (oral board) Interview.

  • Panel (oral board) Interviews will be held on January 30, 2019

Upon completion of all examination processes, the highest scoring applicants will be placed on an Eligibility List. An applicant's ranking on the list will be based on their final score which will be calculated as:

  • 100% of your panel oral board interview

If you are in need of Americans with Disabilities Act-related accommodation during the testing process, please call JoAnn Acosta at 520-837-7008 at least 48 hours prior to the evaluation.

Selection will be made in accordance with CSR III, Section 2. The list of employees eligible for consideration will remain in effect for 6 months after their names are provided to the hiring authorities. Examination results and current status will be communicated by email.

Conclusion

Communications throughout this process will be sent via email exclusively so please ensure your browser accepts emails from jobs@tucsonaz.gov or TucsonFireJobs@tucsonaz.gov and check your email account regularly.  Failure to respond or follow instructions will result in disqualification.  All email inquiries should be directed to JoAnn Acosta, Cynthia Serrano or Antigone Ibrahim at TucsonFireJobs@tucsonaz.gov

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To ensure accurate payroll information for tax purposes, the successful candidate will need to provide their original Social Security Card or original letter from the Social Security Administration with their social security number prior to beginning work with the City of Tucson.

The City of Tucson hires lawful workers only - US citizens or nationals and non-citizens with valid work authorization - without discrimination. Federal immigration laws require all employers to verify both the identity and employment eligibility of all persons hired to work in the United States. In its efforts to meet the law's requirements, the City of Tucson participates in the E-Verify program established by the Department of Homeland Security (DHS) and the Social Security Administration (SSA) to aid employers in verifying the eligibility of workers.

Retired City of Tucson employees receiving benefits from the Tucson Supplemental Retirement System who are considering reemployment with the City should be aware that pursuant to Section 22-37(g) of the Tucson City Code, retirement benefits shall be suspended during the period of reemployment with the City of Tucson unless you have been separated at least twelve consecutive months before returning to work AND you return to a non-permanent employment classification. Creditable service does not accrue during any reemployment period.