Billing Specialist

About Community Care AmbulanceCommunity Care Ambulance is a non-profit, full-service EMS organization serving Northeast Ohio with a commitment to high-quality, patient-centered care. We provide 911 emergency response, interfacility transport, and disaster deployment services across the region.Our success depends not only on the professionals providing care in the field, but also on the dedicated administrative team members who ensure patients, facilities, and insurance providers receive accurate and timely support throughout the billing process.As part of our team, you'll benefit from:Mission-driven, patient-first cultureStable, growing non-profit healthcare organizationSupportive team environment with opportunities for professional growthCompetitive compensation and benefits package401(k) retirement planOngoing training and development opportunitiesMeaningful work supporting emergency medical services in our communitiesBilling Specialist – Duties & Responsibilities(The duties listed are not all-inclusive but represent the essential functions of the role.)Role OverviewThe 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 completenessVerify patient demographic and insurance informationProcess ambulance and wheelchair transport billing claimsEnter and validate charges accurately and efficientlyApply appropriate ambulance coding and billing practicesMaintain a working knowledge of Medicare, Medicaid, commercial insurance carriers, and payer requirementsReview and resolve claim edits, denials, and billing discrepanciesEnsure compliance with medical necessity documentation requirementsFollow up on Medical Certification Statements (MCS) and other required documentationSubmit corrected claims and supporting documentation as necessaryProcess credit card payments and account adjustments as appropriateCustomer Service & Communication (15%)Answer incoming phone calls from patients, facilities, insurance companies, and other stakeholdersProvide professional and courteous customer service while addressing billing inquiriesCommunicate with healthcare facilities to obtain required billing documentation and informationAssist patients and responsible parties with understanding billing statements and insurance processesMaintain positive working relationships with internal and external customersAccount Follow-Up & Collections Support (10%)Monitor outstanding accounts and follow up on unpaid or pending claimsResearch claim status and identify barriers to reimbursementWork collaboratively with team members to maximize claim resolution and reimbursement opportunitiesDocument account activity accurately and thoroughlyTraining & Team Participation (5%)Attend required meetings and training sessionsStay current on payer regulations, billing requirements, and company policiesAssist with departmental projects and process improvement initiativesPerform other duties as assigned by managementQualificationsRequired QualificationsOffice experience/Medical codingBasic proficiency with Microsoft Office applicationsStrong understanding of insurance verification and claims processingExcellent verbal and written communication skillsStrong customer service skills and professional phone etiquetteAbility to work independently and as part of a teamStrong organizational and time-management skillsAbility to prioritize tasks and manage multiple responsibilities in a fast-paced environmentDemonstrated problem-solving and critical-thinking abilitiesStrong attention to detail and commitment to accuracyAbility to meet established productivity and quality standardsPreferred QualificationsExperience with ambulance or EMS billingKnowledge of Medicare, Medicaid, and commercial payer guidelinesFamiliarity with medical necessity requirements and ambulance codingInterpersonal RequirementsMaintain professional, ethical, and organizational standards at all timesDemonstrate accountability and ownership of assigned responsibilitiesExhibit a strong work ethic and commitment to excellenceMaintain a sense of urgency while ensuring accuracy and qualityWork effectively under deadlines and changing prioritiesFoster positive working relationships with co-workers, patients, facilities, and customersCommunicate professionally and respectfully in all interactionsContribute to a positive and collaborative team environmentWork EnvironmentOffice settingLong periods of sitting and computer workFrequent use of telephone and computer systemsModerate office noise levelsOccasional lifting of up to 10 poundsOvertime may be required based on departmental needs and workload #J-18808-Ljbffr