Main Function: Verify insurance coverage, eligibility, and obtain necessary authorizations for billing purposes. Review patient records, medical reports, and related documentation to accurately assign appropriate billing codes for ambulance services per CMS Guidelines Review signature to be sure accurate and signed appropriately in accordance with CMS Guidelines. Prepare and submit claims to insurance companies, ensuring accuracy and adherence to CMS billing guidelines and regulations. Follow up... more details
Main Function:
Verify insurance coverage, eligibility, and obtain necessary authorizations for billing purposes.
Review patient records, medical reports, and related documentation to accurately assign appropriate billing codes for ambulance services per CMS Guidelines
Review signature to be sure accurate and signed appropriately in accordance with CMS Guidelines.
Prepare and submit claims to insurance companies, ensuring accuracy and adherence to CMS billing guidelines and regulations.
Follow up on unpaid claims, denials, and appeals, working closely with insurance companies to resolve any discrepancies.
Coordinate with clients, patients and/or hospital to obtain missing information or clarification required for billing purposes.
Maintain accurate and up-to-date billing records and documentation, ensuring compliance with privacy regulations and confidentiality standards.
Stay updated on industry changes, coding updates, and insurance policies to ensure accurate billing practices.
Collaborate with the billing team to identify opportunities for process improvement and optimize revenue cycle management.
Provide exceptional customer service to clients, patients, insurance companies, and other parties, addressing inquiries and resolving billing-related issues in a professional manner.
Education/Experience:
High school diploma or equivalent (Associate's or Bachelor's degree preferred).
NAAC (National Ambulance Association Coder) Certification
Proven experience as an ambulance biller or medical biller in a healthcare setting.
Proficiency in medical coding systems (ICD-10, CPT, HCPCS) and billing software.
Strong knowledge of insurance guidelines, billing regulations, and reimbursement processes.
Experience with Zoll RescueNet software or similar ambulance billing software.
Familiarity with medical terminology and procedures related to emergency medical services.
Strong communication skills, both written and verbal, with the ability to interact effectively with clients, patients, and insurance companies.
Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
Strong problem-solving skills and a proactive approach to identifying and resolving billing issues.
Familiarity with electronic medical records (EMR) systems and proficiency in Microsoft Office suite
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