Billing Specialist Clearfield EMS - 17496

Billing Specialist Clearfield EMSWe are a growing ambulance company providing both emergent and non-emergent transportation in central Pennsylvania. We operate in a medium-volume environment and are seeking an experienced ambulance biller who can manage the full revenue cycle. This role is designed for someone who takes ownership of A/R, understands payer rules, and is accountable for results.The Ambulance Billing Specialist is responsible for managing the complete billing lifecycle, including charge entry, claim submission, denial management, appeals, payment posting, and accounts receivable follow-up.

This position plays a critical role in protecting company revenue and improving cash flow.Key responsibilities include:Submit clean, accurate ambulance claims in a timely mannerEnsure compliance with CMS ambulance billing guidelinesReview documentation for medical necessity, PCS forms, narratives, and mileageManage accounts receivable and aggressively follow up on unpaid claimsResolve denials, underpayments, and rejectionsPrepare and submit appeals as neededPost and reconcile payments accuratelyIdentify trends in denials and underpayments and recommend corrective actionsCommunicate with operations regarding documentation deficienciesTrack and report billing KPIs, including clean claim rate and A/R agingAssist with audits, payer requests, and compliance reviewsRequired qualifications (non-negotiable):Minimum 1 year of ambulance/medical billing experience OR NAAC Certified Ambulance CoderStrong knowledge of: Medicare and MA ambulance billing guidelines, managed care plans, levels of service billing requirements, PCS forms and medical necessity documentation, modifiers, base rates, and mileage billing, strong working knowledge of ICD-10 diagnosis codesProven experience with denial management and appealsAbility to independently manage A/R and follow-upsHigh attention to detail and strong organizational skillsKnowledge of HIPAA and patient privacy and compliance laws