Job Description
Responsible for knowing, understanding, and following Insurance billing regulations for Non-Emergency and Emergency Ambulance billing. Running and providing department reports for monitoring purposes. Completing and maintaining projects assigned for Medicare/Medicaid.
Key Responsibilities
Responsible for all aspects of Billing and Collections for +11 and Non-Emergency Ambulance Service Providers such as Medicare, Medicaid, and insurance denials.
Provide general administrative and clerical support including but not limited to receiving, maintaining medical records, faxing, copying & scanning.
Responsible for training and coaching team members on new and/or existing procedures.
Responsible for daily, weekly & monthly reporting of following reports & Medicare application compliance items.
Attend industry webinars/conferences and prepare summary to ensure we are up to date with industry & billing compliance standards.
Responsible for reviewing PCS forms to expedite claim submission & collections.
Work closely with Department Managers/Supervisors to create improvement & implement processes to ensure department goals and objectives are met on a consistent basis.
Review weekly CDI lists to ensure accounts are updated timely in effort to expedite claim submission & payment.
Work on Medicare/Medicaid denials to identify trends & expedite claims processing & payment.
Responsible for completing department projects as assigned that will assist in trend analysis, compliance & revenue improvement.
POSITION QUALIFICATIONS
Education & Experience
Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC) preferred.
Extensive Medicare and Medicaid experience and understanding medical necessity in ambulance transportation.
Ambulance/Medical billing certification or diploma preferred.
Maintain working knowledge of ICD-10, CPT and HCPCS coding, NPI, HIPAA, Modifiers, EPCR’s and all forms of medical billing (direct, 3rd party, HMO’s, private pay, no-fault, worker’s comp, Medicare & Medicaid).
Excellent organizational skills and the ability to multi-task in a fast-paced environment.
Review and research data; use intuition and experience to complement data.
Thorough knowledge of transport documentation (PCRs).
Ability to follow up on outstanding Medicare accounts.
Ability to submit appeals and overpayment requests.
Familiar with Medicare/CMS requirements and guidelines.
Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance.
Excellent written and verbal communication skills required.
Excellent documentation skills (promptness, accuracy, thoroughness, and legibility).
Customer Service/Client Relations
Working knowledge of EMS systems/private ambulance and medical transportation systems preferred.
Knowledge of CONNEX preferred.
Knowledge of Microsoft Word, Microsoft Excel, and Microsoft Windows.
Familiarity with medical terminology.
Organizational and leadership abilities, detail-oriented.
Work is performed under normal working conditions, as in a standard office environment.
Physical Requirements
High level of sitting/working at a desk.
Light physical effort (lift/carry up to 10 lbs.).
Must be able to perform the essential duties of the position with or without reasonable accommodations.
We are an equal opportunity employer. Our recruitment, selection, and hiring strategies are designed to attract, develop and advance exceptional individuals regardless of race, color, ****** orientation, religion, age, gender, disability, or any other legally protected status. We actively recruit military veterans.
Key Responsibilities
Responsible for all aspects of Billing and Collections for +11 and Non-Emergency Ambulance Service Providers such as Medicare, Medicaid, and insurance denials.
Provide general administrative and clerical support including but not limited to receiving, maintaining medical records, faxing, copying & scanning.
Responsible for training and coaching team members on new and/or existing procedures.
Responsible for daily, weekly & monthly reporting of following reports & Medicare application compliance items.
Attend industry webinars/conferences and prepare summary to ensure we are up to date with industry & billing compliance standards.
Responsible for reviewing PCS forms to expedite claim submission & collections.
Work closely with Department Managers/Supervisors to create improvement & implement processes to ensure department goals and objectives are met on a consistent basis.
Review weekly CDI lists to ensure accounts are updated timely in effort to expedite claim submission & payment.
Work on Medicare/Medicaid denials to identify trends & expedite claims processing & payment.
Responsible for completing department projects as assigned that will assist in trend analysis, compliance & revenue improvement.
POSITION QUALIFICATIONS
Education & Experience
Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC) preferred.
Extensive Medicare and Medicaid experience and understanding medical necessity in ambulance transportation.
Ambulance/Medical billing certification or diploma preferred.
Maintain working knowledge of ICD-10, CPT and HCPCS coding, NPI, HIPAA, Modifiers, EPCR’s and all forms of medical billing (direct, 3rd party, HMO’s, private pay, no-fault, worker’s comp, Medicare & Medicaid).
Excellent organizational skills and the ability to multi-task in a fast-paced environment.
Review and research data; use intuition and experience to complement data.
Thorough knowledge of transport documentation (PCRs).
Ability to follow up on outstanding Medicare accounts.
Ability to submit appeals and overpayment requests.
Familiar with Medicare/CMS requirements and guidelines.
Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance.
Excellent written and verbal communication skills required.
Excellent documentation skills (promptness, accuracy, thoroughness, and legibility).
Customer Service/Client Relations
Working knowledge of EMS systems/private ambulance and medical transportation systems preferred.
Knowledge of CONNEX preferred.
Knowledge of Microsoft Word, Microsoft Excel, and Microsoft Windows.
Familiarity with medical terminology.
Organizational and leadership abilities, detail-oriented.
Work is performed under normal working conditions, as in a standard office environment.
Physical Requirements
High level of sitting/working at a desk.
Light physical effort (lift/carry up to 10 lbs.).
Must be able to perform the essential duties of the position with or without reasonable accommodations.
We are an equal opportunity employer. Our recruitment, selection, and hiring strategies are designed to attract, develop and advance exceptional individuals regardless of race, color, ****** orientation, religion, age, gender, disability, or any other legally protected status. We actively recruit military veterans.
💡 Quick Summary
Seeking a career-building opportunity? The Medical Biller/Coder Posted About + Hours Ago Poughkeepsie, NY Hybrid Remote position is now open for candidates interested in the Government Job Alert sector. This role in Adams offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Government Job Alert is a plus.
