Medical Billing Specialist I (A262913-2), 202, Ambulance

About the role

The role involves handling new claims, generating and processing emergency ambulance transport medical claims, determining appropriate CPT and ICD 10 codes, and supporting the management of numerous medical claims related to EMS services.

Responsibilities

• Reviews, generates, and processes emergency ambulance transport medical claims
• Determines appropriate CPT and ICD 10 codes based on medical data and ePCR
• Serves as support staff for managing medical claims
• Retrieves hospital face sheets and obtains health insurance information
• Determines primary, secondary, and tertiary insurance sequences
• Sends CMS1500 forms when necessary
• Submits electronic claims and reviews transmission reports
• Reviews claim batches and ensures they clear the billing system
• Processes medical and billing record requests in response to subpoenas and other requests
• Provides customer service to patients via phone and in person
• Takes payments and submits medical and billing record requests
• Assists with daily work assignments and performs other clerical tasks

Requirements

• Knowledge of ICD-10, CPT, and HCPCS medical coding
• Knowledge of Medicare and Medicaid guidelines
• Knowledge of health insurance claim submission and collections
• Knowledge of HIPAA guidelines
• Knowledge of complex medical office clerical and billing services and operations

Skills

• Solving mathematical problems pertaining to patient accounts and billing functions
• Built and maintained effective working relationships
• Clear and effective communication both orally and in writing
• Maintained good planning and organizational skills
• Followed directions from supervisor and gave directions to assigned staff
• Project a positive and professional image
• Effective communication in English and Spanish
• Complied with City of Laredo policies and procedures
• Maintained good health and physical condition

Qualifications

• High School Diploma or GED
• At least six (6) months of experience in medical coding, working with Medicare or Medicaid, working with insurance claims, or clerical experience in a medical office

Benefits

• 10 days of paid vacation per year
• 6 1/2 days sick leave per year
• Pension plan
• 16 paid holidays
• Paid health and dental plans