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Ambulance Billing Specialist

2 months ago

Memphis, Tennessee, United States TEAM MOBILE HEALTH CARE Full time
Position Overview

Role Summary:

This role is crucial for ensuring the precise and prompt billing of ambulance services while adhering to quality and efficiency benchmarks. The incumbent will evaluate diagnoses and service levels based on the details provided in the Patient Care Report (PCR) and will accurately apply the necessary coding for billing purposes.

Key Responsibilities:

  • Conduct a thorough review of essential patient information, including name, address, date of birth, social security number, and insurance details, making updates as required.
  • Confirm receipt of and amend Patient Care Service (PCS) information for non-emergency or scheduled trips, including verifying payor preauthorization.
  • Ensure accuracy in service details such as pick-up and drop-off locations, dates and times, call types, response priorities, and transport priorities.
  • Assess medical information to identify the correct service codes, ICD-10, or condition codes pertinent to the patient's complaints.
  • Determine the appropriate charges for services rendered and procedures performed.
  • Identify the correct procedure codes and modifiers necessary for billing, as dictated by the payor.
  • Report any additional information required for billing processes.
  • Prepare claims for services rendered, ensuring all necessary details, modifiers, indicators, condition codes, and documentation are included for submission to primary payors.
  • Ensure compliance with HIPAA regulations concerning billing practices.
  • Maintain accurate records of all trips and claims processed.
  • Verify that the number of electronic Patient Care Reports (ePCRs) received matches the total trips for the day.
  • Stay informed about all coding regulations, particularly those relevant to the assigned state or payor.
  • Organize and maintain files for all trips and associated medical documentation.
  • Engage in continuous cross-training across various functional areas.

Additional Responsibilities:

Other duties may be assigned as necessary.