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Priority Patient Transport

Ambulance and NEMT Coding Billing Specialist

Posted a day ago
Worldwide
$40000 - $45000 per year
2-5 years experience
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AI Summary

The specialist will review transport documentation for medical necessity and accuracy to ensure claims are prepared and submitted correctly. They will also manage the revenue cycle by tracking claim statuses, resolving documentation gaps, and communicating with internal and external stakeholders.

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$40,000 - $45,000 a year

About the Role

We are seeking an Ambulance and NEMT Billing Coding Specialist to support the revenue cycle for emergency and nonemergency medical transportation services. This position reviews transport documentation, confirms patient and payer information, resolves documentation gaps, prepares accurate claims, and helps move each trip from intake through claim submission and follow-up.

The ideal candidate is organized, detail-oriented, comfortable working independently, and able to collaborate with billing leadership, QA and QI staff, dispatchers, field personnel, facilities, transportation brokers, patients, and families.

What You Will Do

  • Review ambulance and NEMT transport records for completeness, accuracy, medical-necessity support, and consistency across dispatch records, ePCRs, trip documents, and billing systems.
  • Verify patient demographics, insurance eligibility, payer order, transport type, service level, origin and destination, mileage, authorization or reference numbers, and other required billing information.
  • Prepare and code claims according to company procedures and applicable payer requirements, including Medicare, Medicaid, commercial insurance, managed transportation, facility, and self-pay workflows.
  • Confirm that required documents are present and attached, such as facesheets, physician certification statements, signatures, manifests or trip logs, authorizations, vouchers, vendor approvals, and advance beneficiary notices.
  • Identify incomplete or conflicting documentation, record the issue, place the account in the correct review status, and request corrections or missing information from the appropriate person or organization.
  • Review ePCRs for consistency in personnel and signatures, incident details, times, mileage, patient information, assessment findings, narratives, vitals, procedures, destination information, and billing indicators.
  • Follow approved correction and addendum procedures and escalate clinical, payer, or compliance questions when requirements are unclear.
  • Enter or import completed transports into the billing platform, update claim statuses, submit claims through approved channels, and maintain accurate work queues.
  • Track rejected, denied, suspended, or incomplete claims; research the cause; correct or route the account; and communicate unresolved barriers.
  • Perform required provider, signer, or exclusion checks using approved sources, including Office of Inspector General checks when applicable.
  • Maintain production and documentation-issue logs and help identify trends affecting clean claims, billing timeliness, reimbursement, or compliance.
  • Provide professional documentation feedback and assist with staff orientation or training when requested.
  • Protect patient and company information in accordance with HIPAA, privacy, security, and confidentiality requirements.
  • Support billing-office communications and cross-coverage and perform other related duties within the position scope.

What We Are Looking For

  • High school diploma or equivalent.
  • Two or more years of experience in EMS, ambulance, NEMT, medical transportation, medical billing, coding, claims, or a related revenue-cycle function preferred.
  • Working knowledge of insurance verification, authorizations, claim documentation, billing workflows, and payer portals.
  • Ability to read detailed transport and clinical records, identify inconsistencies, maintain organized account notes, and prioritize work independently.
  • Comfort using computers, email, Microsoft Office, and dispatch, ePCR, billing, document-management, and payer systems.
  • Clear written and verbal communication skills and the ability to work professionally with internal teams and external partners.
  • Ability to meet job-related background-screening and drug-testing requirements, consistent with applicable law and company policy.

Preferred Qualifications

  • Certified Ambulance Coder or comparable ambulance billing or compliance training.
  • Experience with both ambulance and NEMT claims.
  • Experience reviewing ePCRs, physician certification statements, signatures, trip logs, prior authorizations, claim edits, and denials.

Work Setting and Schedule

This is an hourly, nonexempt, primarily office-based position. The anticipated schedule is Monday through Friday, 8:00 a.m. to 4:00 p.m. Occasional evening or weekend work and limited travel may be required for meetings or training. The role involves extended computer and telephone use, handling paper and electronic records, moving within an office, and sustained attention to detailed information. Reasonable accommodations may be provided to qualified individuals in accordance with applicable law.

Equal Employment Opportunity

The employer provides equal employment opportunities to qualified applicants and employees in accordance with applicable law. Employment decisions are based on job-related qualifications, performance, and business needs.

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