United States onlyWork Location: Pafford Medical Services, Inc. - Oklahoma City
Division/Department: PMBS
Reports To: Director of Pafford Medical Services Billing
- Full-Time
- Nonexempt
Job Description:
Responsible for charge validation and assigning appropriate ICD-10 and HCPCS codes to ambulance claims. Responsible for reviewing ambulance trip reports to determine medical necessity and to assign the appropriate level of care. Includes fulfilling assigned duties and responsibilities for the accurate submission of all ambulance transports in order to process third party claims and patient bills.
Essential Duties and Responsibilities:
- Researches all information to complete accurate billing processes including assignment of billing charge codes and ICD-10 diagnosis codes
- Prioritize workflow to ensure timely claim submission
- Knowledge of state and federal insurance regulations
- Ability to analyze and problem solve complex issues
- Knowledge of billing requirements, coverage and benefits
- Uphold Medicare, Medicaid and HIPAA guidelines
- Identifies and communicates documentation issue trends
- Reports quality and documentation issues to the department head
Qualifications:
- Knowledge of procedure and diagnostic codes (HCPCS and ICD-10 codes)
- Knowledge of medical terminology
- Researches all information to complete accurate billing processes including assignment of billing charge codes and ICD-10 diagnosis codes
- Prioritize workflow to ensure timely claim submission
- Knowledge of state and federal insurance regulations
- Ability to analyze and problem solve complex issues
- Knowledge of billing requirements, coverage and benefits
- Uphold Medicare, Medicaid and HIPAA guidelines
- Identifies and communicates documentation issue trends
- Reports quality and documentation issues to the department head
- Knowledge of Medical Billing
- Ability to work independently and with a group
- Working knowledge of MS Word, Excel
- Ability to maintain effective working relationships.
- Ability to type at least 35 words per minute.
- Proficiency using 10 key
- EMT or Paramedic with a minimum of 2 years of field experience, or
- Minimum of 2 years of ambulance coding experience, or
- Minimum of 1 year of ambulance coding experience and current certification as a Certified Ambulance Coder (CAC) or other recognized medical coding credential
Other Requirements:
- Reliable access to high-speed internet
- Ability to travel to Oklahoma City for an initial 2-week training period and quarterly for staff education sessions
- Preference given to candidates residing in the Central Time Zone
Physical Requirements:
- Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
- Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.
- The employee may occasionally be required to lift and/or move up to 20 pounds
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
- Work may require sitting, lifting, stooping, bending, stretching, walking, standing, pushing, pulling, reaching, and other physical exertion.
- Must be able to talk, listen and speak clearly on telephone.
- Must possess visual acuity to prepare and analyze data and figures, operate a computer terminal, and operate a motor vehicle.
Travel Time: Negligible
NOTE: The above statements are intended to describe the general nature and level of work being performed by the
person assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, skills and
physical demands required of personnel so classified.
