Job Description

This is a new role with EMS Unlimited - be a part of our growing team as we transition to bringing ambulance billing in-house! In this role you will be a part of implementation and development. Must be able to complete CAC and CAFO within 1 month. Must have previous experience in medical billing.

This can be a hybrid work environment with occasional work from home opportunities but most work will be conducted at the corporate office in Rifle, Colorado. The ideal candidate will have at least 5 years of experience in medical billing.

Relocation reimbursement available for the ideal candidate

POSITION TITLE:

Biller/Coder - Certified Ambulance Coder, Certified Ambulance Financial Officer

Salary:

• Starting at $75,000 per year + performance bonuses

POSITION IDENTIFICATION:

Reports to: President

• Full Time, year-round, Salary, OT Exempt
• Medical/Dental/Vision
• 401K Retirement with 4% match
• Wellness Stipend
• Uniform Allowance
• Total Rewards Package
• Paid Time Off
• A drug free workplace
• An Equal Opportunity Employer (EEO)
• At-will employment

Job Summary:

This position is geared toward verification of transport and patient data as well as compliant coding and billing with appropriate payer claims specifications and accompanying documentation. This position performs demographic and medical coverage verification, identifies transport call, response and mission type disparities and reviews for appropriate vehicle type, pickup, drop off locations, mileage, and transport dates, and assigns the appropriate Level of Service and Diagnosis Codes to all ambulance claims. The position is responsible for document retrieval and professional communication with Customers, Call Centers and facility Patient Financial Services Staff. Applicant must have at least 5 years of experience with medical billing and claim submission. This position requires a candidate that is highly detail oriented, able work in a fast-paced environment with high volume, accurate data entry.

Essential Functions:

1. Verify accurate data completion by Communication/Dispatch Specialists and Medical Clinicians. Details to include patient locations, loaded mileage and patient demographics.
2. Thoroughly and appropriately document all activities in patient account notes.
3. Retrieve, retain and interpret Federal and Industry Standard Signature Documents, ensuring uniformed and compliant billing practices and clean claim submission.
4. Perform data entry of patient demographic information and charges, within billing software, as appropriate for claims submission and financial reporting.
5. Perform in-depth sponsor review investigations to identify, collect, and confirm third party liability and coordination of benefits insurance coverage.
6. Interact on an as needed basis, with leadership, customers, crew members, law enforcement agencies, insurance companies, patients and hospital patient information systems to collect additional patient and payer demographic information.
7. Performs Medicare as a Secondary Payor (MSP) review, coordination of benefits and generate invoices to patients as needed.
8. Apply the appropriate level of service for the transport provided using the Customer Scope of Practice.
9. Assign the most accurate diagnosis codes from the crew documentation ensuring highest level of specificity and considering payor guidelines or local coverage determination requirements.
10. Assign modifiers appropriate to the locations for the transport as well as any payor required modifiers.
11. Initiate insurance billing transactions; transmit electronically and/or prepare claims packets for payers in accordance with payer specific claim requirements.
12. Screens for clean claims submission pursuant to payer specific guidelines, and billing form requirements.
13. May assist with billing/collection tasks as assigned.
14. Required to act as back-up support in the performance of client financial liaison duties
15. Other responsibilities as assigned.

DIMENSIONS:
1. Ability to work independently and demonstrate consistent customer focus
2. Ability to analyze and make good billing/collections decisions keeping in mind the goals and objectives of the department
3. Recognize the entire scope of an issue and participate objectively towards resolution with other team members.
4. Maintains professional personal appearance.
5. Ability to verbally communicate details and understand parameters of job responsibilities to perform in a Hospital Systems setting.
6. Initiative required learning company organization and procedures.
7. Is a team player and interfaces well with employees.
8. Display competency, business professionalism, patient advocacy in all communications both (verbal and written) and interpersonal relations.
9. Ability to provide written communication using best business practices when composing letters, memorandums, and e-mails regardless if the communication is inside the Company or with customers, clients, or providers.
10. Must maintain the highest professional and ethical standards in conducting day-to-day business. Adheres to all Company HIPAA compliance regulations, business and professional ethics, and confidentiality and privacy regulations as outlined in the Corporate Code of Conduct, the Employee Handbook, and the PFS Department policies and procedures.
11. Requires an in depth understand of compliance, regulatory oversight bodies and payer requirements.
12. Represents the company in a positive, customer friendly attitude to other employees, clients, agencies, entities and patients.
13. No supervisory or budget responsibilities.
14. Focus on continuous improvement, learning, accountability, and teamwork

Additional Information

All information will be kept confidential according to EEO guidelines.