Medical Billing and Coding Associate

DocGo•Madison, WI

4d•$24 - $29

About The Position

The Medical Billing and Coding Associate codes and bills ambulance transportation claims and works with Operations to resolve issues involving unbilled claims, authorizations, Physician Certification Statements, Patient Care Reports, insurance, and demographic information. The role handles claim follow-up, appeals, billing corrections, account reconciliation, and patient and payer inquiries. It requires knowledge of ambulance billing, payer requirements, CPT and ICD-10 coding, and Medicare and Medicaid medical-necessity rules. The position is based in Madison, Wisconsin, and is full-time.

Requirements

Extensive Medicare and Medicaid experience and understanding of medical necessity in ambulance transportation.
Proficiency in CPT and ICD-10 coding.
Obtain Certified Ambulance Coder (CAC) certification within 30 days of employment; company sponsored.

Nice To Haves

Medical billing experience preferred, but not required.
Ambulance billing experience preferred.
Ambulance or medical billing certification or diploma preferred.

Responsibilities

Partner with Operations to resolve issues involving unbilled claims, authorizations, Physician Certification Statements (PCSs), Patient Care Reports (PCRs), insurance, and demographic capture.
Code and bill ambulance transportation claims.
Escalate concerns about questionable paperwork to appropriate management.
Contact payers by phone or web to verify claim status and follow up on unpaid claims.
Process appeals on aged insurance claims and denials.
Analyze, identify, and resolve issues that may delay payer payment.
Identify and resolve claim edits by applying billing guidelines and payer requirements.
Reconcile commercial and government accounts and ensure CPT and diagnostic codes are accurate.
Interpret terms for Managed Care, Commercial, Medicare, Medicaid, Workers' Compensation, and No Fault when applicable.
Review EOBs for correct payment, deductible, adjustments, and denials.
Determine claim status with insurers and whether claims meet contractual agreements or need adjustment.
Reconcile account balances and verify that payments are applied correctly.
Maintain well-aged accounts and promptly resolve and resubmit denied or unpaid claims.
Follow up on appeals and corrected claims.
Review and correct billing errors using knowledge of CPT and ICD-10 coding.
Review and audit customer service account inquiries.
Handle inbound and outbound customer service calls.
Perform internal recovery calls and manage well-aged self-pay accounts.
Provide customer service to patients, insurers, and facilities.
Review and correct rejections in the clearinghouse.
Perform other related duties as assigned.