Billing Specialist

About Community Care Ambulance Community Care Ambulance is a non-profit, full-service EMS organization serving Northeast Ohio with a commitment to high-quality, patient-centered care. We provide 911 emergency response, interfacility transport, and disaster deployment services across the region. Our success depends not only on the professionals providing care in the field, but also on the dedicated administrative team members who ensure patients, facilities, and insurance providers receive accurate and timely support throughout the billing process. As part of our team, you'll benefit from: Mission-driven, patient-first culture Stable, growing non-profit healthcare organization Supportive team environment with opportunities for professional growth Competitive compensation and benefits package 401(k) retirement plan Ongoing training and development opportunities Meaningful work supporting emergency medical services in our communities Billing Specialist - Duties & Responsibilities (The duties listed are not all-inclusive but represent the essential functions of the role.) Role Overview The Billing Specialist is responsible for ensuring accurate and timely processing of ambulance and wheelchair transport claims. This position works closely with patients, healthcare facilities, insurance carriers, and internal departments to verify information, resolve billing issues, maintain compliance with payer requirements, and support the organization's revenue cycle operations. Billing & Claims Processing (70%) Review patient accounts for billing accuracy and completeness Verify patient demographic and insurance information Process ambulance and wheelchair transport billing claims Enter and validate charges accurately and efficiently Apply appropriate ambulance coding and billing practices Maintain a working knowledge of Medicare, Medicaid, commercial insurance carriers, and payer requirements Review and resolve claim edits, denials, and billing discrepancies Ensure compliance with medical necessity documentation requirements Follow up on Medical Certification Statements (MCS) and other required documentation Submit corrected claims and supporting documentation as necessary Process credit card payments and account adjustments as appropriate Customer Service & Communication (15%) Answer incoming phone calls from patients, facilities, insurance companies, and other stakeholders Provide professional and courteous customer service while addressing billing inquiries Communicate with healthcare facilities to obtain required billing documentation and information Assist patients and responsible parties with understanding billing statements and insurance processes Maintain positive working relationships with internal and external customers Account Follow-Up & Collections Support (10%) Monitor outstanding accounts and follow up on unpaid or pending claims Research claim status and identify barriers to reimbursement Work collaboratively with team members to maximize claim resolution and reimbursement opportunities Document account activity accurately and thoroughly Training & Team Participation (5%) Attend required meetings and training sessions Stay current on payer regulations, billing requirements, and company policies Assist with departmental projects and process improvement initiatives Perform other duties as assigned by management Qualifications Required Qualifications Office experience/Medical coding Basic proficiency with Microsoft Office applications Strong understanding of insurance verification and claims processing Excellent verbal and written communication skills Strong customer service skills and professional phone etiquette Ability to work independently and as part of a team Strong organizational and time-management skills Ability to prioritize tasks and manage multiple responsibilities in a fast-paced environment Demonstrated problem-solving and critical-thinking abilities Strong attention to detail and commitment to accuracy Ability to meet established productivity and quality standards Preferred Qualifications Experience with ambulance or EMS billing Knowledge of Medicare, Medicaid, and commercial payer guidelines Familiarity with medical necessity requirements and ambulance coding Interpersonal Requirements Maintain professional, ethical, and organizational standards at all times Demonstrate accountability and ownership of assigned responsibilities Exhibit a strong work ethic and commitment to excellence Maintain a sense of urgency while ensuring accuracy and quality Work effectively under deadlines and changing priorities Foster positive working relationships with co-workers, patients, facilities, and customers Communicate professionally and respectfully in all interactions Contribute to a positive and collaborative team environment Work Environment Office setting Long periods of sitting and computer work Frequent use of telephone and computer systems Moderate office noise levels Occasional lifting of up to 10 pounds Overtime may be required based on departmental needs and workload