Job Abstract

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