Ambulance Revenue Cycle and Appeals Specialis

Acute Rescue and Transport Inc•Boise, ID

1d•Hybrid

About The Position

Acute Rescue is looking to hire an Ambulance Revenue Cycle and Appeals Specialists with a head for figures and a heart for helping others. Everyone on our administrative team has a role to play in providing great customer service for a broad cross-section of clients, so you will get to use your excellent communication and interpersonal skills, as well as accuracy in this demanding role. After your probationary period, you may qualify for our robust Benefits package. Best of all, you'll have the chance to leave every day knowing you've helped others as part of a caring staff. This role manages the ambulance billing cycle from post-claim submission through payment collection, requiring a thorough understanding of ambulance billing, insurance claims, insurance appeal processes, and compliance regulations, including familiarity with Idaho State rules and regulations regarding the Idaho Patient Act.

Requirements

High school diploma or equivalent.
Minimum of 5 years of experience specifically in ambulance billing. General medical billing experience does not satisfy this requirement.
Strong knowledge of ambulance billing procedures, commercial and supplemental insurance plans, and healthcare regulations, including Medicare and Medicaid.
Proficiency in using billing software and electronic medical records (EMR) systems.
Excellent analytical and problem-solving skills.
Strong attention to detail and accuracy.
Effective communication and interpersonal skills.
Ability to manage time effectively and work independently.
Compassionate and empathetic communication skills.
If working remotely, must maintain a HIPAA-compliant secure network and internet connection.

Nice To Haves

Ambulance Billing and Coding Specialist certification preferred.
Experience with Logis billing is a plus.

Responsibilities

Handle collections on past-due accounts by making outbound calls to patients and insurance companies to secure payment.
Resubmit denied claims to insurance companies with appropriate appeals, corrections, or documentation, and follow up on outstanding claims.
Review and resolve claim rejections, denials, and appeals in a timely manner.
Adjudicate claims, ensuring they meet payer requirements, and file appeals when necessary to obtain payment, including communicating with insurance providers, hospitals, and patients to clarify and resolve billing issues or missing information.
Identify claims rejected due to provider credentialing issues and coordinate with Administration to resolve outstanding credentialing needs and support timely claim resubmission.
Apply late fees and other processing fees to overdue accounts according to company policy and legal guidelines.
Process payments for patients and make appropriate notations in patient and claim accounts.
Set up and manage patient payment plans to facilitate manageable payments and reduce outstanding balances.
Exhaust all internal collections efforts prior to submitting delinquent accounts to collection agencies.
Maintain up-to-date knowledge of billing regulations, codes, and standards specific to ambulance services, including Medicare and Medicaid.
Ensure proper documentation and coding of all ambulance services rendered.
Collaborate with internal teams to gather necessary information for accurate billing.
Prepare and send patient statements and handle inquiries regarding delinquent bills.
Monitor accounts receivable and take necessary actions to collect overdue payments.
Generate regular reports on billing and collection activities for management review.
If working remotely, participate in weekly virtual meetings to discuss challenges, account status, and progress updates.