What are the responsibilities and job description for the Billing Specialist Clearfield EMS position at Penn Highlands Healthcare?
We are a growing ambulance company providing both emergent and non-emergent transportation in central Pennsylvania. We operate in a medium-volume environment and are seeking an experienced ambulance biller who can manage the full revenue cycle. This role is designed for someone who takes ownership of A/R, understands payer rules, and is accountable for results.
Role Summary
The Ambulance Billing Specialist is responsible for managing the complete billing lifecycle, including charge entry, claim submission, denial management, appeals, payment posting, and accounts receivable follow-up. This position plays a critical role in protecting company revenue and improving cash flow.
Key Responsibilities
• Submit clean, accurate ambulance claims in a timely manner • Ensure compliance with CMS ambulance billing guidelines • Review documentation for medical necessity, PCS forms, narratives, and mileage • Manage accounts receivable and aggressively follow up on unpaid claims • Resolve denials, underpayments, and rejections • Prepare and submit appeals as needed • Post and reconcile payments accurately • Identify trends in denials and underpayments and recommend corrective actions • Communicate with operations regarding documentation deficiencies • Track and report billing KPIs, including clean claim rate and A/R aging • Assist with audits, payer requests, and compliance reviews Required Qualifications (Non-Negotiable) • Minimum 1 year of ambulance/medical billing experience OR NAAC Certified Ambulance Coder • Strong knowledge of: o Medicare and MA ambulance billing guidelines o Managed care plans o Levels of Service Billing requirements o PCS forms and medical necessity documentation o Modifiers, base rates, and mileage billing o Strong Working knowledge of ICD-10 diagnosis codes • Proven experience with denial management and appeals • Ability to independently manage A/R and follow-ups • High attention to detail and strong organizational skills • Knowledge of HIPAA and Patient Privacy and Compliance Laws
Benefits:
Health Insurance, Vacation & Paid Time Off, 401K Plan