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Sarnova

Prebill Specialist I - Digitech - Remote

Posted 8 days ago
0-2 years experience
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AI Summary

The Prebill Specialist I is responsible for accurately verifying patient demographics, payor details, and transport modifiers to ensure claims are ready for coding. They must also maintain compliance with HIPAA regulations and meet daily production and quality goals.

The Sarnova Family of companies includes Digitech Computer, Bound Tree Medical, Tri-anim Health Services and Cardio Partners.

 

Digitech is a leading provider of advanced billing and technology services to the EMS transport industry. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle. Digitech leverages its proprietary technology to offer fully outsourced services that maximize collections, protect compliance, and deliver results for clients.

 

Summary:

 

The Prebill Specialist I (PBSI) plays a key role in Digitech’s RCM process by accurately and efficiently verifying prebill information—including patient demographics, payor details, and transport modifiers—before coding. The PBSI ensures all required information is thoroughly reviewed and correctly entered on each transport claim prior to coding. This role is essential to upholding Digitech’s quality standards and supporting our vision of being the trusted partner of choice that 100% of our clients would recommend to a friend or colleague

 

Essential Duties and Responsibilities:

 

  • Utilize preferred system tools (hospital registration system, face sheet, HL7 feed, etc.) to locate insurance and patient demographic information
  • Place claims in the Insurance Discovery workflow when no insurance is found
  • Accurately enter patient demographics 
  • Follow the Master Billing Guide instructions to select the appropriate modifiers and payors for the transport
  • Follow the SOPs to select the appropriate modifiers, tags, and payors
  • If required, call facility payor (SNF, Assisted Living, Hospice) to confirm appropriate transport modifiers
  • Participate in Prebill Huddles to review and align on processes
  • Upon verifying patient, payor, and modifier information, place the claim in the appropriate tag for the next step
  • Consistently achieve or exceed the Prebill Specialist’s daily production and quality goals
  • Adhere to all Digitech HIPAA privacy policies and procedures. This includes always maintaining the confidentiality and security of sensitive patient information
  • Additional job duties as assigned

 

Skills/Experience Required:

 

  • Education: High School Diploma or equivalent  
  • 1+ year of revenue cycle management experience preferred
  • Ability to identify problems and escalate issues appropriately to Prebill Lead 
  • Motivated self-starter, independent thinker capable of working both independently and within a collaborative team environment 
  • RCM experience preferred 
  • Working knowledge of health insurance verification and basic understanding of major payor groups (Medicare, Medicaid, Commercial), preferred
  • Ability to learn and maintain a growing knowledge of various state regulations and payor guidelines
  • Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment

Sarnova is an Equal Opportunity Employer. We offer a competitive salary, commensurate with experience, along with a comprehensive benefits package, including 401(k) Plan.  EO/M/F/Veterans/Disabled.

 

Our mission is to be the best partner for those who save and improve patients’ lives.  Excellence in delivering upon our mission is dependent upon having a diverse team that is empowered to bring their full, authentic self to work each day.  We strive to create a workplace that reflects the communities we serve, and we are passionate about creating an inclusive workplace that promotes and values diversity.

 

#digitech

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