Medical Billing and Coding Specialist II

This is a fully remote position, open to applicants in United States.

📋 Description

• Leverage Master Billing Guides and other procedural instructions to assess PCR for medical necessity, reasonableness, appropriate modifiers, level of service, ICD10 codes, and mileage.

• Execute the Billing quality scrub process.

• Validate PCS when necessary.

• Review Medicare AOB if required.

• Tag claims appropriately when additional information is required.

• Participate actively in daily Billing team huddles.

• Consistently meet performance and quality metrics for Billing Specialist II.

• Ensure accurate billing complies with regulatory standards and internal policies and procedures.

• Exhibit billing competency by achieving and maintaining accuracy scores that meet or exceed expectations during quality assurance and audit processes.

• Follow Digitech HIPAA privacy policies and procedures, ensuring the confidentiality and security of sensitive patient data.

• Carry out additional job responsibilities as assigned.

⛳️ Requirements

• High School Diploma or equivalent qualification.

• Preferred: 2+ years of experience in EMS Billing.

• Preferred: Certified Ambulance Coder (CAC).

• Demonstrated capability or willingness to obtain QMC Biller Certification upon employment.

• Highly detail-oriented.

• Strong working knowledge of EMS billing rules and regulations.

• Understanding of health insurance payer groups (Medicare, Medicaid, Commercial).

• Ability to identify issues and escalate them appropriately to a Billing Lead.

• Capacity to quickly adapt, learn, and retain evolving rules and specifications from clients, payors, states, and MAC regions.

• Quality-focused and driven by process.

• Preferred knowledge of EMS billing platforms.

• Ability to independently manage all aspects of the job role, including meeting required goals and business practices in a remote setting.

🏝️ Benefits

• Competitive salary based on experience.

• Comprehensive benefits package.

• 401(k) Plan.

• Remote work environment.