Ambulance Billing and Coding Specialist

Medical Express Ambulance Service•Skokie, IL

11h

About The Position

We are seeking an experienced and detail-oriented Ambulance Billing and Coding Specialist to support our EMS revenue cycle operations. This role is responsible for accurate ambulance claim submission, coding review, insurance verification, denial management, and compliance with Medicare, Medicaid, HIPAA, and other regulatory requirements. The ideal candidate will possess strong knowledge of ambulance billing, medical coding, reimbursement processes, and insurance regulations.

Requirements

Knowledge of ambulance billing procedures and diagnostic coding, including HCPCS and ICD-10 codes
Strong understanding of medical terminology, claims processing, denials management, and reimbursement practices
Ability to analyze information and solve complex billing and coding issues
Knowledge of insurance regulations, billing requirements, coverage guidelines, and benefits eligibility
Ability to work independently and collaboratively within a team environment
Proficiency in Microsoft Word and Excel
Strong organizational, communication, and interpersonal skills
Ability to maintain effective working relationships and confidentiality
Typing speed of at least 35 words per minute
Minimum of 2 years of ambulance coding or EMS billing experience; OR Minimum of 1 year of ambulance coding experience with current certification as a Certified Ambulance Coder (CAC) or other recognized medical coding credential

Nice To Haves

EMT or Paramedic with a minimum of 2 years of field experience
Experience with EMS billing software, claims auditing, or NEMSIS documentation review preferred
Strong attention to detail and accuracy
Ability to manage multiple priorities in a fast-paced environment
Commitment to compliance and confidentiality standards
Experience identifying process improvements and documentation trends
Strong problem-solving and critical-thinking abilities
Knowledge of revenue cycle management (RCM) and ambulance reimbursement practices

Responsibilities

Research and review all information necessary to complete accurate ambulance billing processes, including assignment of billing charge codes, HCPCS codes, and ICD-10 diagnosis codes
Prioritize workflow to ensure timely and accurate claim submission and reimbursement
Review claims for completeness and compliance prior to submission
Analyze and resolve complex claim, reimbursement, and denial management issues
Verify billing requirements, insurance coverage, authorizations, and benefits eligibility
Maintain current knowledge of Medicare ambulance billing guidelines, Medicaid requirements, HIPAA regulations, and commercial insurance policies
Identify and communicate documentation trends, deficiencies, and quality assurance concerns to leadership
Collaborate effectively with billing, coding, dispatch, and operational departments as needed
Assist with continuous process improvement initiatives related to revenue cycle management (RCM), claims processing, and billing operations
Support accounts receivable (AR) follow-up and appeals processes as needed