Senior Ambulance Billing Specialist

Carolina First EMS • Elgin, SC

14h

About The Position

We are hiring a seasoned ambulance billing professional to own our insurance revenue cycle end to end - from claim preparation and submission through denials, appeals, and accounts receivable. This is a single-owner role for an experienced specialist who can run the billing function independently, hold a high standard for submission speed and clean-claim accuracy, and maximize legitimate reimbursement across Medicare, Medicare Advantage, Medicaid managed care, and commercial payers.

Requirements

• 10+ years of dedicated ambulance / EMS medical billing experience.
• Expert knowledge of the Medicare Ambulance Fee Schedule and ambulance-specific coding - ALS / BLS / SCT levels, origin and destination modifiers, condition codes, and mileage.
• Proven experience billing Medicare, Medicare Advantage, Medicaid managed care, and commercial payers for ambulance services.
• Strong denial management and appeals track record.
• Working knowledge of medical necessity and Physician Certification Statement requirements.
• Experience submitting electronic claims through a clearinghouse.
• Highly accurate, organized, and able to own the billing function with minimal oversight.

Nice To Haves

• NAAC Certified Ambulance Coder (CAC) or an equivalent ambulance-billing credential.
• Hands-on experience with ImageTrend Billing Bridge.
• South Carolina Medicaid and regional payer experience.

Responsibilities

• Prepare and submit clean ambulance claims within 48 hours of completed trip documentation.
• Code transports accurately, including service levels (ALS, BLS, SCT), HCPCS codes, origin and destination modifiers, condition codes, and mileage.
• Verify patient insurance eligibility and secure prior authorizations where required.
• Ensure medical necessity documentation, including Physician Certification Statements, is complete and compliant.
• Post insurance payments, EOBs, and ERAs.
• Work claim rejections, denials, and appeals; correct and resubmit promptly.
• Manage accounts receivable and aging; follow up on unpaid and underpaid claims.
• Maintain compliance with Medicare ambulance billing regulations and individual payer requirements.
• Track and report on submission timeliness, clean-claim rate, collections, and denial trends.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed