Ambulance Billing Specialist
1 week ago
Position Summary:
This role is essential for ensuring the precise and prompt billing of ambulance services while adhering to quality and efficiency benchmarks. The individual in this position will assess diagnoses and service levels based on the information provided in the Patient Care Report (PCR) and will accurately code for billing purposes.
Key Responsibilities:
- Conducts a secondary verification of essential patient information, including but not limited to name, address, date of birth, social security number, and insurance details, making updates as required.
- Confirms receipt of and updates Patient Care Service (PCS) information for non-emergency or scheduled trips, as well as verifying payor preauthorization for services rendered.
- Reviews and updates service specifics, including pick-up and drop-off locations, date and time of service, type of call, response priority, and transport urgency.
- Evaluates medical information to determine the appropriate service codes, ICD-10, or condition codes corresponding to the patient's complaints.
- Ensures the correct billing amount for services provided and procedures performed is established.
- Identifies the correct procedure codes and necessary modifiers for billing, as dictated by the payor.
- Communicates any additional information that may be required.
- Prepares claims for services rendered, either on paper or in the appropriate electronic format, ensuring all necessary details, modifiers, indicators, condition codes, and documentation are included for submission to primary payors.
- Maintains compliance with HIPAA regulations concerning billing practices.
- Tracks all trips and claims meticulously.
- Ensures that the number of ePCRs received matches the total trips conducted for the day.
- Stays informed about all coding regulations, particularly those relevant to the assigned state or payor.
- Maintains organized files for all trips and medical documentation.
- Engages in continuous cross-training across various functional areas.
Additional Duties: Other responsibilities may be assigned as necessary.
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