PCS Specialist
Superior Ambulance Service
Overview
Have a profound knowledge in the PCS process to identify system and/or coding errors and provide feedback to management in the following areas:
o Tab 7 reason
o Valid PCS attach but sending for new one
o Coders dumping claims in PCS schedule
o No attempts to identify for valid PCS
o DR name not being requested for the rolodex
o Other realizations to improve the PCS process
Responsibilities
- Review all the proper PCS workflow’s and ensure claims are being followed up on timely
- Attach and review any PCS forms received by fax or mail and bill out the claim to appropriate payer and schedule/event
- Mail and attach POM to Medicare claims within the 21 day billing mark. Ensure Medicare claims are being followed up on within 72 hours of each the 3 attempts for a DR name
- Responsible for auditing claims on hold for PCS, bill out claims that have a valid PCS form, and provide feedback to management for educational purposes
o MI MCD MCOS
o MI Medicaid
o ISSUES PCS
- Maintain a thorough understanding of running reports through excel and power BI
o Tab 7 missing
o ZOI PCS picture not attached
o PCS barcoded not attached
- Keep a communication channel between support and front end billing in order to support the need of area improvements and to promote insurance collections/compliance initiatives
- Establish expert knowledge for the required guidelines for PCS forms and be able to catch errors missed while billing
- Mail out batch PCS print jobs daily
- Tracking POM’s to ensure we have received all mail dates and pages back from post office.
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