Ambulance Billing Specialist
MTI Ambulance
About the Role We are a growing ambulance company providing non-emergent Ambulance Services throughout California . Due to our high-volume environment, we are seeking an experienced Ambulance Billing Specialist who understands the complexities of ambulance reimbursement and can take full ownership of the revenue cycle. This is not an entry-level billing position. We are looking for someone who is experienced, accountable, detail-oriented, and results-driven , with a proven ability to manage claims, resolve denials, work A/R, and maximize reimbursement. The ideal candidate will be comfortable working independently, understanding payer requirements, identifying documentation issues, and aggressively following up on outstanding accounts.
Key Responsibilities
Key Responsibilities
- Manage the full ambulance billing and revenue cycle process , from charge entry through final payment
- Submit clean, accurate, and timely claims to Medicare, Medi-Cal, managed care plans, and other payers
- Review patient and transport documentation for billing accuracy and compliance
- Verify medical necessity, PCS forms, transport narratives, mileage, and level of service
- Apply appropriate billing codes, modifiers, base rates, and mileage charges
- Manage and prioritize accounts receivable (A/R) to maximize collections and reduce aging
- Perform consistent payer follow-up on unpaid, delayed, and underpaid claims
- Research and resolve claim rejections, denials, underpayments, and payment discrepancies
- Prepare and submit effective appeals and reconsiderations when claims are denied
- Post and reconcile insurance and patient payments accurately
- Identify recurring denial and underpayment trends and recommend corrective action
- Communicate with operations, dispatch, and field staff regarding missing or incomplete documentation
- Monitor billing performance and maintain accurate records of claim status and follow-up activity
- Track and report key billing metrics, including:
- Clean claim rate
- A/R aging
- Collection performance
- Denial rate
- Appeal outcomes
- Unresolved claims
- Assist with payer audits, documentation requests, compliance reviews, and other revenue-cycle projects
- Maintain strict confidentiality and comply with applicable billing, privacy, and regulatory requirements
- At least 2-3 years of hands-on ambulance billing experience
- Strong working knowledge of Medicare ambulance billing guidelines
- Experience billing Medi-Cal and Medi-Cal managed care plans
- Strong understanding of ambulance levels of service and billing requirements
- Experience with PCS forms and medical necessity documentation
- Knowledge of ambulance modifiers, base rates, mileage, and transport billing
- Strong working knowledge of ICD-10-CM diagnosis coding
- Proven experience handling denials, rejections, underpayments, and appeals
- Demonstrated ability to independently manage A/R and payer follow-up
- Excellent attention to detail and strong organizational skills
- Ability to work efficiently in a high-volume billing environment
- Strong communication and problem-solving skills
- Ability to take ownership of assigned accounts and follow issues through to resolution
- Take ownership of their A/R
- Know how to research and resolve difficult claims
- Understand why claims are being denied-not just how to resubmit them
- Be persistent with payer follow-up
- Catch documentation and billing issues before they become lost revenue
- Understand the financial impact of clean claims and timely follow-up
- Work independently while communicating effectively with the rest of the organization
- Be accountable for results and committed to continuously improving the billing process
- Experience with ambulance billing software or EMS billing platforms
- Experience working with California ambulance providers
- Experience with Medicare, Medi-Cal, and commercial ambulance payers
- Familiarity with payer portals and electronic claim submission
- Experience preparing formal appeals and reconsiderations
- Experience tracking billing KPIs and A/R performance
Vacancy posted 4 days ago
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