Quick Med Claims - PreBill Specialist I

Quick Med Claims (QMC) is a nationally recognized leader in emergency medical transportation billing and reimbursement. QMC is committed to providing services in a manner that ensures compliance with all applicable billing and reimbursement regulations while maximizing the capture of allowable reimbursement for each client. The commitment to adherence to both principles make QMC the partner of choice for emergency medical transportation providers. 

This position is 100% work from home.

Summary:

The Prebill Specialist I (PBSI) plays a key role in QMC’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 QMC’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 & 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.

Other Responsibilities

• Adhere to all QMC HIPAA privacy policies and procedures. This includes always maintaining the confidentiality and security of sensitive patient information.
• Ensures consistent adherence to company attendance policies.

Education:

• High School Diploma required 

Experience:

• 1+ years of Revenue Cycle Management preferred  

Knowledge, Skills, Abilities:

• 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