Medical Claims Specialist

Join Our Growing Team at Physicians Ambulance Service!

Physicians Ambulance Service is seeking a detail-oriented and experienced Claims Specialist to join our billing department. As a trusted provider of private ambulance services, we are committed to delivering exceptional patient care and maintaining efficient billing operations. This role is crucial in ensuring timely reimbursement and maintaining positive relationships with patients and healthcare facilities.

Position Overview

The Claims Specialist will be responsible for managing the complete lifecycle of medical claims, from preparation through payment resolution. This position requires a blend of technical billing expertise, analytical problem-solving skills, and exceptional customer service abilities.

Key ResponsibilitiesClaims Management

• Prepare and submit accurate medical claims to insurance companies, Medicare, Medicaid, and other payers
• Follow up on unpaid, underpaid, and denied claims to ensure maximum reimbursement
• Research and resolve claim rejections and denials through appeals and resubmissions
• Monitor claim status and aging reports to prioritize collection efforts
• Ensure compliance with payer-specific billing requirements and regulations

Data Management

• Verify and enter patient insurance information and demographics into billing systems
• Maintain accurate and up-to-date patient account records
• Review and validate CPT, ICD-10, and HCPCS coding for ambulance services
• Process electronic remittance advice (ERA) and explanation of benefits (EOB)

Customer Service

• Take inbound customer service phone calls from patients and healthcare facilities
• Answer billing-related questions professionally and courteously
• Resolve patient billing inquiries and concerns
• Coordinate with dispatch and operations teams to obtain necessary documentation
• Communicate with insurance companies regarding coverage and authorization issues

Additional Responsibilities

• Generate and analyze billing reports to identify trends and opportunities for improvement
• Participate in month-end closing procedures
• Maintain knowledge of current Medicare and insurance regulations affecting ambulance billing
• Assist with patient payment plans and financial assistance applications
• Collaborate with team members to meet department goals and deadlines

Required QualificationsEducation & Experience

• High school diploma or equivalent required; Associate's degree in Healthcare Administration, Business, or related field preferred
• Minimum 2 years of experience in medical billing, preferably in ambulance or emergency medical services
• Experience with Medicare Part B billing strongly preferred

Technical Skills

• Proficiency in medical billing software and electronic health records (EHR) systems
• Strong knowledge of CPT, ICD-10, and HCPCS coding
• Understanding of insurance verification processes and payer requirements
• Excellent computer skills including Microsoft Office Suite
• Experience with clearinghouse submissions and electronic claims processing

Core Competencies

• Attention to Detail: Ability to maintain accuracy while managing high-volume workload
• Communication: Excellent verbal and written communication skills for interacting with patients, providers, and payers
• Problem-Solving: Strong analytical skills to research and resolve complex billing issues
• Organization: Ability to prioritize tasks and manage multiple deadlines effectively
• Customer Focus: Commitment to providing compassionate and professional service
• Team Collaboration: Ability to work independently and as part of a team

Preferred Qualifications

• Certified Professional Biller (CPB) or Certified Professional Coder (CPC) certification
• Experience with ambulance-specific billing modifiers and documentation requirements
• Knowledge of HIPAA regulations and compliance
• Bilingual capabilities (English/Spanish) a plus

What We Offer

• Competitive salary commensurate with experience
• Comprehensive benefits package including health, dental, and vision insurance
• 401(k) retirement plan with company match
• Paid time off and holidays
• Professional development opportunities
• Stable work environment with a respected healthcare provider
• Opportunity to make a difference in emergency medical services

Work Environment

• Office-based position with standard business hours
• Fast-paced environment requiring the ability to manage multiple priorities
• Regular interaction with internal teams and external stakeholders

About Physicians Ambulance Service

Physicians Ambulance Service has been providing professional emergency and non-emergency medical transportation services to our community for years. We pride ourselves on delivering compassionate, high-quality care while maintaining the highest standards of operational excellence. Our billing team plays a vital role in sustaining our mission by ensuring accurate and timely reimbursement for services rendered.

How to Apply

Interested candidates should submit their resume and cover letter through really. Please highlight your relevant medical billing experience, particularly any ambulance or EMS billing background.

Physicians Ambulance Service is an Equal Opportunity Employer

We are committed to creating a diverse and inclusive workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

Job Type: Full-time

Pay: $22.00 - $27.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Vision insurance

Work Location: In person

Salary : $22 - $27