Revenue Cycle Oversight:

• Manage end-to-end ambulance billing operations including charge entry, coding, claims submission, payment posting, and collections
• Monitor key performance indicators (KPIs) such as days in A/R, collection rates, denial rates, and cash flow
• Identify and implement strategies to improve reimbursement and reduce revenue leakage

Ambulance Billing & Compliance:

• Ensure proper use of EMS billing codes, including HCPCS and modifiers specific to ground and air ambulance services
• Maintain compliance with Centers for Medicare & Medicaid Services (CMS), Medicare, Medicaid, and commercial payer guidelines
• Stay current on ambulance fee schedules, local coverage determinations (LCDs),and documentation requirements

Denials & A/R Management:

• Oversee denial management processes, including root cause analysis and appeals
• Reduce aged receivables and improve collection turnaround time
• Work closely with billing staff to resolve complex claims and payer issues

Team Leadership:

• Supervise billing, coding, and A/R staff (internal or outsourced vendors)
• Provide training on ambulance billing regulations, documentation standards, and system workflows
• Establish productivity benchmarks and conduct performance evaluations

Client / Stakeholder Collaboration:

• Partner with EMS leadership, fire departments, and third-party billing vendors
• Provide regular reporting and insights on revenue performance
• Support contract negotiations with payers and billing partners

Systems & Process Improvement:

• Optimize billing software and electronic patient care reporting (ePCR) integrations
• Lead automation and workflow improvements to increase efficiency
• Ensure data integrity across systems

Required Qualifications:

• Bachelor’s degree in healthcare administration, business, finance, or related field (or equivalent experience)
• Minimum 3 years of experience managing a revenue cycle team, preferably in EMS or ambulance billing
• Strong knowledge of Medicare/Medicaid ambulance billing rules and payer requirements
• Experience managing A/R, denials, and collections

Preferred Qualifications:

• Experience with ambulance billing platforms (e.g., ESO, ImageTrend, Zoll)
• Familiarity with NEMSIS data standards
• Certification such as CPC (Certified Professional Coder) or CPB (Certified Professional Biller)

Key Competencies:

• Analytical mindset with strong attention to detail
• Leadership and team development skills
• Process improvement and problem-solving ability
• Strong communication skills with both clinical and financial stakeholders