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The Ambulance Billing Representative plays a crucial role in the revenue cycle management of the ambulance service, operating under the guidance of the Revenue Cycle Director and the Billing Manager. This position is primarily responsible for the accurate processing and management of claims related to ambulance services. The representative must ensure that all patient information, insurance details, and service levels are documented correctly and that claims are coded, submitted, and processed in compliance with established regulations. The role requires a thorough understanding of billing procedures, including the handling of denied claims and follow-ups on outstanding payments, necessitating effective communication with both patients and insurance companies. In addition to processing claims, the Ambulance Billing Representative is tasked with reviewing Patient Care Reports (PCRs) for completeness and accuracy, ensuring that all necessary signatures are obtained. The representative must also determine when additional documentation is required before submission and possess knowledge of how to post and collect payments. Familiarity with insurance communication and the ability to resolve unpaid claims are essential skills for this role. The representative is expected to prepare credits or refunds when necessary and submit all bills in a timely, compliant, and complete manner. Meeting productivity standards and goals is a critical aspect of the job, along with a commitment to improving operations and providing high-quality customer service. The position requires a minimum of two years of experience in a similar role, along with a high school diploma or equivalent. Proficiency in Zoll software, Waystar, and Sansio is preferred, as is a solid understanding of CMS regulations and electronic claim submissions. The representative must also be well-versed in HIPAA rules and possess excellent interpersonal, written, and verbal communication skills. Computer proficiency is also preferred, as the role involves significant interaction with electronic systems and documentation.
