Ambulance Billing & Revenue Cycle Specialist

EPOCH HEALTHCARE LLC•Norwood, MA

11d•Onsite

About The Position

Epoch Health Care LLC is seeking an experienced Ambulance Billing & Revenue Cycle Specialist to manage the full billing cycle for our BLS and non-emergency medical transport services. You will handle claims submission, payment posting, denials management, and collections for Medicare, MassHealth (Medicaid) and commercial insurers. This is a critical role that directly supports Epoch's financial health and regulatory compliance as we expand our ambulance operations throughout the Greater Boston area.

Requirements

Minimum 2 years of experience in medical billing, with at least 1 year in ambulance or EMS billing
Working knowledge of Medicare ambulance fee schedule (42 CFR Part 414, Subpart H) and MassHealth transportation billing regulations
Proficiency in ICD-10-CM diagnosis coding and HCPCS Level II ambulance procedure codes (A0425–A0999)
Experience with electronic claims submission (EDI 837P) and ERA/EOB payment posting
Familiarity with EMS billing software (e.g., Zoll Billing, EMS Billing Services, TriTech, or similar)
Strong understanding of HIPAA Privacy Rule and ambulance billing compliance requirements
High school diploma or GED required
Must not appear on OIG List of Excluded Individuals/Entities (LEIE)

Nice To Haves

Associate's degree in Accounting, Health Information, or related field preferred
Certified Ambulance Coder (CAC) or Certified Professional Biller (CPB) designation
Experience billing for MassHealth (Massachusetts Medicaid) ambulance transport services and PT-1 forms
Knowledge of MTM and other non-emergency medical transportation (NEMT) broker billing
Experience with Medicare medical necessity documentation review for ambulance transport
Bilingual (English/Spanish or English/Haitian Creole) a strong plus
Prior experience with a small or startup ambulance company — ability to work independently

Responsibilities

Process and submit clean ambulance claims to Medicare, MassHealth, and commercial insurers electronically and by paper
Enter BLS/ALS level-of-service codes, mileage, diagnosis codes (ICD-10), and procedure codes (HCPCS A-codes) accurately
Review and interpret patient care reports (PCRs) to verify documentation supports the level of service billed
Post payments, adjustments, contractual allowances, and denials to patient accounts
Manage denials and rejections — perform claim corrections, appeals, and payer follow-up
Verify patient insurance eligibility and obtain prior authorizations when required
Submit PT-1 forms and transportation authorization requests for MassHealth members
Monitor accounts receivable aging reports and follow up on outstanding claims
Set up patient payment plans and respond to billing inquiries from patients and payers
Ensure all billing practices comply with Medicare, MassHealth, HIPAA, and OIG guidelines
Generate billing reports and provide revenue cycle metrics to management
Coordinate with EMTs, Paramedics, and operations staff to resolve documentation issues