Emergency Services Billing Analyst,

Optum is dedicated to improving health data flow and creating a connected healthcare system. The Emergency Services Billing Analyst will coordinate EMS billing and regulatory compliance activities, train staff, ensure quality in billing processes, and prepare month-end reports.

Responsibilities:

• Coordination and implementation of Emergency Medicine Services (EMS) billing and regulatory compliance activities
• Coordination of all aspects of EMS, and regulatory / billing compliance requirements
• Training of EMS staff to ensure regulatory and / or billing compliance
• Ensure that the EMS staff are appropriately training in the required aspects and are operating effectively
• Coordinate and implement all Emergency Medical Services (EMS) billing and regulatory compliance activities
• Ensure quality and accuracy of EMS billing processes and compliance requirements
• Train EMS staff on all regulatory, billing, and documentation requirements; ensure staff are operating effectively and meeting standards
• Prepare and deliver all required month end reporting, including but not limited to:001P Excel Version Executive Summary Reports (ESR)0366 Finance Officer Summary (EFO)0365 Administrator Summary (EFA)Client Run Reconciliation reports for all transports exported from Image TrendRevenue distribution by level of service (LOS)Reports of all charges, receipts, provider affiliation, vehicle affiliation, and ownership/maintenance
• Compile and maintain a list of denied claims and corresponding payer denial descriptions
• Generate report suites showing all imported transports and their current billing/coding status
• Monitor and return transports missing required coding or billing elements
• Send deposit logs to PGFD for all revenue posted to Lockbox, EFT, refunds, and VA
• Analyze LOS performance and payer mix to identify variances, anomalies, or trends
• Monitor days in A/R and review account processing
• Review all systematic and manually keyed write offs
• Determine whether Courtesy Transports qualify for billing or must remain non billable
• Ensure all client return corrections are processed for billing
• Respond to incoming inquiries related to ambulance billing
• Fulfill periodic requests for specialty EMS reports
• Schedule and conduct an annual revenue performance meeting with the Fire Chief, ESC, ASC, and EMS leadership
• Ensure all provider and vehicle affiliations are correct and updated in all systems
• Address data concerns related to revenue splits; work with VSC on anomalies and required corrections
• Prepare and send refund packages with required supporting documentation
• Maintain inventory, process repair requests, and provide PGFD with all damage reports
• Ensure EMS software is current; manage updates, small hardware issues, and repair orders
• Respond to questions about current status of ambulance transport run reports
• Provide status updates for ambulance transports in EMS coding
• Process requests for revenue information and reporting from MDIV
• Provide copies of statements and information regarding patient communications when requested
• Send monthly service fee invoices to pgfdinvoices@co.pg.md.us
• Process all Ambulance Billing mail received onsite and route accordingly
• Ensure PGFD receives all EMS Billing updates and provide training when needed
• Maintain billing operations during regular hours (0830-1700, Monday-Friday), following vendor holiday schedules
• Travel between fire stations as needed