Senior Ambulance Billing Specialist in Elgin, South Carolina at Carolina First EMS

At Carolina First EMS, we put high-quality health-care within your reach. Whether you use a wheelchair or require stretcher transport, we have the equipment and expertise you need to get to your appointments on-time and hassle-free.Whether you live in an extended care facility or the same house you moved into 50 years ago, we specialize in helping you make full use of our community’s healthcare options.

Position Summary

We are hiring a seasoned ambulance billing professional to own our insurance revenue cycle end to end - from claim preparation and submission through denials, appeals, and accounts receivable. This is a single-owner role for an experienced specialist who can run the billing function independently, hold a high standard for submission speed and clean-claim accuracy, and maximize legitimate reimbursement across Medicare, Medicare Advantage, Medicaid managed care, and commercial payers.

Key Responsibilities

• Prepare and submit clean ambulance claims within 48 hours of completed trip documentation.

• Code transports accurately, including service levels (ALS, BLS, SCT), HCPCS codes, origin and destination modifiers, condition codes, and mileage.

• Verify patient insurance eligibility and secure prior authorizations where required.

• Ensure medical necessity documentation, including Physician Certification Statements, is complete and compliant.

• Post insurance payments, EOBs, and ERAs.

• Work claim rejections, denials, and appeals; correct and resubmit promptly.

• Manage accounts receivable and aging; follow up on unpaid and underpaid claims.

• Maintain compliance with Medicare ambulance billing regulations and individual payer requirements.

• Track and report on submission timeliness, clean-claim rate, collections, and denial trends.

Required Qualifications

• 10+ years of dedicated ambulance / EMS medical billing experience.

• Expert knowledge of the Medicare Ambulance Fee Schedule and ambulance-specific coding - ALS / BLS / SCT levels, origin and destination modifiers, condition codes, and mileage.

• Proven experience billing Medicare, Medicare Advantage, Medicaid managed care, and commercial payers for ambulance services.

• Strong denial management and appeals track record.

• Working knowledge of medical necessity and Physician Certification Statement requirements.

• Experience submitting electronic claims through a clearinghouse.

• Highly accurate, organized, and able to own the billing function with minimal oversight.

Preferred Qualifications

• NAAC Certified Ambulance Coder (CAC) or an equivalent ambulance-billing credential.

• Hands-on experience with ImageTrend Billing Bridge.

• South Carolina Medicaid and regional payer experience.

Performance Standards

• Clean claims submitted within 48 hours of trip documentation.

• High clean-claim acceptance rate and strong net collection performance.

• Accounts receivable kept current, with denials and appeals worked on a defined cycle.