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We are seeking a knowledgeable and detail‑oriented Certified Ambulance Biller / Coding Specialist to join our billing team. This role is responsible for reviewing patient care reports, applying proper ambulance billing codes, ensuring compliance with federal and state regulations, and submitting clean claims for timely reimbursement. The ideal candidate understands EMS industry billing practices and has experience with accurate documentation review and denial prevention.
Job Responsibility:
Review Patient Care Reports (PCRs), run sheets, and supporting documentation for accuracy and completeness
Apply correct ambulance billing codes, including HCPCS, CPT, and ICD‑10, according to documentation and payer requirements
Determine appropriate levels of service (BLS, ALS1, ALS2, SCT, mileage, etc.) based on medical necessity and documentation
Enter and validate charges in the billing system prior to claim submission
Ensure compliance with Medicare, Medicaid, and commercial payer guidelines
Identify missing or insufficient documentation and coordinate follow‑up with field staff or supervisors
Process claims, resolve edits, and prepare bills for submission
Review and correct returned or denied claims to support quick resolution
Maintain accurate records and meet productivity/quality benchmarks
Stay current on EMS billing regulations, compliance updates, and coding changes
Assist with internal audits and quality assurance reviews as needed
Strong understanding of medical-necessity requirements
Knowledge of reimbursement guidelines and compliance laws (HIPAA, CMS regulations)
Accuracy in data entry and coding
Ability to work independently while meeting deadlines
Comfortable collaborating with EMS crews, supervisors, and the billing team
Requirements:
Certification as a Certified Ambulance Coder (CAC), Certified Ambulance Documentation Specialist (CADS), or equivalent EMS billing certification
Additional certifications such as CPB, CPC, or other medical billing/coding credentials (preferred)
1–3 years of ambulance billing, medical billing, or coding experience (preferred but not required with proper certification)
Strong knowledge of Medicare and Medicaid ambulance billing rules
Ability to read and interpret medical documentation and apply proper codes
High attention to detail with strong analytical and problem‑solving skills
Excellent communication and follow‑up abilities
Proficiency with billing software systems and Microsoft Office applications
Associate Degree
Nice to have:
Additional certifications such as CPB, CPC, or other medical billing/coding credentials
1–3 years of ambulance billing, medical billing, or coding experience