Remote Ambulance Coder

Job Title: Remote Ambulance Coder
Work Location: Pafford Medical Services, Inc. - Oklahoma City
Division/Department: PMBS
Reports To: Coding Supervisor

• Full-Time
• Nonexempt

The Ambulance Coder is responsible for reviewing ambulance patient care reports (PCRs) and accurately assigning diagnosis, procedure, level-of-service, and other required billing codes based on the clinical documentation provided. This position evaluates the patient's condition, services rendered, medical necessity, origin and destination, and transport circumstances to support accurate and compliant ambulance billing.

The Ambulance Coder applies Medicare, Medicaid, commercial payer, and other applicable regulatory requirements when determining the appropriate level of service and coding for ambulance transports.

Essential Duties and Responsibilities

• Review ambulance patient care reports and supporting medical documentation for completeness and coding accuracy.
• Interpret clinical documentation, including the patient's condition, symptoms, assessment findings, interventions, medications, monitoring, and response to treatment.
• Determine the appropriate ambulance level of service based on the patient's condition and documented services provided.
• Assign accurate ICD-10-CM diagnosis codes based on the condition chiefly responsible for the ambulance transport and other relevant documented conditions.
• Assign appropriate HCPCS ambulance codes, including BLS, ALS1, ALS2, Specialty Care Transport (SCT), and other applicable ambulance services.
• Apply appropriate ambulance modifiers based on the documented origin and destination.
• Review documentation to determine whether the transport meets applicable medical necessity requirements.
• Evaluate documentation supporting emergency and non-emergency ambulance transportation.
• Identify documentation deficiencies, inconsistencies, or missing information that may affect coding, medical necessity, or reimbursement.
• Refer documentation requiring clarification or additional review through the appropriate clinical or coding process.
• Validate mileage, supplies, procedures, medications, and other billable services when applicable.
• Apply Medicare, Medicaid, and payer-specific ambulance coverage and coding requirements.
• Maintain compliance with CMS regulations, HIPAA requirements, organizational policies, and applicable federal and state regulations.
• Remain current on changes to ICD-10-CM, HCPCS, Medicare ambulance regulations, payer policies, and industry coding guidance.
• Participate in coding audits, education, and quality-improvement activities.
• Meet established productivity and accuracy standards while maintaining coding quality and compliance.
• Work collaboratively with billing, clinical documentation, compliance, operations, and revenue cycle staff to resolve coding and documentation issues.

Minimum Qualifications

• Strong understanding of medical terminology, anatomy, physiology, disease processes, and emergency medical services.
• Knowledge of ICD-10-CM and HCPCS coding principles.
• Knowledge of ambulance levels of service, including BLS, ALS1, ALS2, and SCT.
• Ability to interpret EMS clinical documentation and identify the patient's primary reason for transport.
• Understanding of ambulance medical necessity and coverage requirements.
• Ability to distinguish between the services available, services performed, and services required by the patient's condition when determining the appropriate level of service.
• Strong analytical skills and attention to detail.
• Ability to recognize documentation that does not adequately support the level of service or medical necessity.
• Ability to work independently while maintaining established productivity and quality expectations.
• Effective written and verbal communication skills.
• Ability to maintain confidentiality of protected health information.

Education and Experience Requirements

• EMT or Paramedic with a minimum of 2 years of field experience, or
• Minimum of 1 year of ambulance coding experience and current certification as a Certified Ambulance Coder (CAC) or other recognized medical coding credential
• Other areas of education will be considered in lieu of experience.

Physical Requirements

• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
• Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.
• The employee may occasionally be required to lift and/or move up to 20 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
• Work may require sitting, lifting, stooping, bending, stretching, walking, standing, pushing, pulling, reaching, and other physical exertion.
• Must be able to talk, listen and speak clearly on telephone.
• Must possess visual acuity to prepare and analyze data and figures, operate a computer terminal, and operate a motor vehicle.

Other Requirements:

Candidates must reside within 100 miles of either Oklahoma City, Oklahoma, or Hope, Arkansas to be considered for this position.

Candidates who reside more than 100 miles from these locations may also be considered if they live in Oklahoma, Arkansas, Texas, Mississippi, or Louisiana and have a minimum of three years of ambulance coding experience.

Initial training will take place in either the Oklahoma City or Hope, AR office and may require in-person attendance for up to four weeks. Additional in-person training may be required periodically throughout the year.

Because this position includes remote work, candidates must have reliable high-speed internet access. Internet speed and connectivity will be tested and must meet company requirements before an offer of employment.

NOTE: The above statements are intended to describe the general nature and level of work being performed by the person assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, skills and physical demands required of personnel so classified.