Epoch Health Care LLC, a medical transportation and emergency medical services company, is seeking an Ambulance Billing & Revenue Cycle Specialist. The role involves managing the full billing cycle for BLS and non-emergency medical transport services, including claims submission, payment posting, denials management, and collections for Medicare, MassHealth (Medicaid), and commercial insurers. Key duties include processing ambulance claims, entering level-of-service codes, reviewing patient care reports, posting payments and adjustments, managing denials and appeals, verifying insurance eligibility, submitting authorization requests, monitoring accounts receivable, setting up payment plans, ensuring billing compliance with Medicare, MassHealth, HIPAA, and OIG guidelines, generating billing reports, and coordinating with EMTs and paramedics to resolve documentation issues.
Required qualifications include a minimum of 2 years of medical billing experience (at least 1 year in ambulance or EMS billing), knowledge of Medicare ambulance fee schedule and MassHealth billing regulations, proficiency in ICD-10-CM and HCPCS ambulance procedure codes, experience with electronic claims submission and payment posting, familiarity with EMS billing software, understanding of HIPAA privacy and ambulance billing compliance, and a high school diploma or GED (associate degree preferred). Preferred qualifications include Certified Ambulance Coder (CAC) or Certified Professional Biller (CPB) designation, experience with MassHealth ambulance transport billing and PT-1 forms, knowledge of non-emergency medical transportation broker billing, experience with Medicare medical necessity documentation, bilingual abilities, and prior experience with small/startup ambulance companies.
Physical demands include the ability to lift at least 125 lbs with assistance, walk stairs carrying equipment, and work in varied environments.
Benefits include 401(k), performance bonuses, company parties, free uniforms, and opportunities for advancement.
Minimum 2 years medical billing experience, 1 year ambulance/EMS billing; Knowledge of Medicare ambulance fee schedule and MassHealth billing; Proficiency in ICD-10-CM and HCPCS codes; Electronic claims submission experience; Familiarity with EMS billing software; Understanding of HIPAA and ambulance billing compliance; High school diploma or GED required, associate degree preferred; No OIG LEIE exclusion.
Preferred: CAC or CPB certification; MassHealth ambulance billing and PT-1 forms experience; NEMT broker billing knowledge; Medicare medical necessity documentation review; Bilingual English/Spanish or English/Haitian Creole; Startup ambulance company experience.
401(k) Bonus based on performance Company parties Free uniforms Opportunity for advancement
Location
Massachusetts, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago