Medical Biller

he Billing Specialist is responsible for ensuring accurate and timely processing of ambulance and wheelchair transport claims. This position works closely with patients, healthcare facilities, insurance carriers, and internal departments to verify information, resolve billing issues, maintain compliance with payer requirements, and support the organization's revenue cycle operations.

Billing & Claims Processing (70%)

• Review patient accounts for billing accuracy and completeness

• Verify patient demographic and insurance information

• Process ambulance and wheelchair transport billing claims

• Enter and validate charges accurately and efficiently

• Apply appropriate ambulance coding and billing practices

• Maintain a working knowledge of Medicare, Medicaid, commercial insurance carriers, and payer requirements

• Review and resolve claim edits, denials, and billing discrepancies

• Ensure compliance with medical necessity documentation requirements

• Follow up on Medical Certification Statements (MCS) and other required documentation

• Submit corrected claims and supporting documentation as necessary

• Process credit card payments and account adjustments as appropriate

Customer Service & Communication (15%)

• Answer incoming phone calls from patients, facilities, insurance companies, and other stakeholders

• Provide professional and courteous customer service while addressing billing inquiries

• Communicate with healthcare facilities to obtain required billing documentation and information

• Assist patients and responsible parties with understanding billing statements and insurance processes

• Maintain positive working relationships with internal and external customers

Account Follow-Up & Collections Support (10%)

• Monitor outstanding accounts and follow up on unpaid or pending claims

• Research claim status and identify barriers to reimbursement

• Work collaboratively with team members to maximize claim resolution and reimbursement opportunities

• Document account activity accurately and thoroughly

Training & Team Participation (5%)

• Attend required meetings and training sessions

• Stay current on payer regulations, billing requirements, and company policies

• Assist with departmental projects and process improvement initiatives

• Perform other duties as assigned by management