• Billing Representative

    Requisition ID
    Employment Type
    Regular Full-Time
  • More Information about this Job



    The Coding Representative is responsible for the accurate and timely billing of ambulance transports, while maintaining the quality and productivity standards set for the Coding Representative.   The incumbent is expected to determine diagnosis and levels of service based on information provided on the Patient Care Report (PCR) and to accurately bill, using the appropriate codes.


    Essential Duties and Responsibilities:

    • Review and/or determine the appropriate primary source of payment
    • Determine the appropriate Level of Service to be billed, based on supporting documentation on the PCR and/or in the Computer Aided Dispatch (CAD) notes, including but not limited to, designating Advanced Life Support (ALS), Basic Life Support (BLS), or Specialty Care Transport (SCT)/Critical Care Transport (CCT)
    • Update and add insurance coverage to the Accounts Receivable Billing System after verification of benefits
    • Assign proper condition codes, procedure codes, primary and secondary modifiers and identify excessive mileage
    • Create narrative in the Accounts Receivable Billing System to document status of trip
    • Assign ancillary procedures to charges when applicable, based on payor-specific guidelines, (e.g. IV treatment and oxygen)
    • Make outbound calls as needed to obtain additional information on insurance coverage, patient demographics, and/or to verify inpatient or Part A status
    • Run “Journal Entry” report daily to verify accuracy of data entered
    • Verify that a Physician Certification Statement or a Letter of Medical Necessity has been received and contains the required information/signatures
    • Forward to appropriate “Collection Plan” and request additional information on claims that do not have the required Physician Certification or a Letter of Medical Necessity and apply appropriate trip status and collection plan
    • Adhere to all company policies and procedures

    Non-Essential Duties and Responsibilities:

    • Be flexible with shifting daily priorities
    • Meet deadlines, working within tight time constraints
    • Handle a large volume of work
    • Identify pertinent information from supporting documentation on reports or other documents
    • Process claims with accuracy and attention to detail
    • Meet or exceed established standards for productivity and quality
    • Perform other duties as assigned

    Minimum Qualifications:Education/Licensing/Certification:

    High School Diploma or GED required; certificate of completion from a coding and billing school preferred


    Experience: Minimum one (1) or more years previous medical billing experience preferred, ambulance billing experience strongly preferred


    Knowledge and Skills:

    • Terminology on a PCR, Hospital Face Sheet, and/or a CAD Sheet
    • Medical terminology and insurance terminology
    • Process of signature and paperwork compliance
    • HIPAA requirements
    • Proficient in the Accounts Receivable Billing System and Internet tools, (e.g. Internet mapping programs, eligibility websites, address search engines)
    • Computer literacy / 35 WPM
    • Communicate effectively, (both orally and in writing) in English

    Company offers Great Benefits: 

    • Medical, Dental and Vision Care
    • Life Insurance
    • Short-Term and Long-Term Disability
    • Employee Assistance Program
    • 401(k) Retirement Plan with a Company Match
    • Paid Time Off
    • Holiday Pay
    • Employee Discount Programs


    EEO Statement

    EOE including Veterans and Disabled


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