Medical Transport Billing Specialist II

Medical Transport Billing Specialist II

This role executes daily revenue cycle tasks and processes air medical transport claims to ensure timely reimbursement and account resolution. The Air Medical Billing Specialist manages RMA selected billing software, handles inbound/outbound patient communication, and collects copays and balances in compliance with company standards. In addition Medical Transport Billing Specialist II is responsible for managing Independent Dispute Resolution (IDR) and denied claims and claim appeals.

Core Responsibilities:

• Operations & Workflow:
  Process daily air ambulance claims, manage revenue cycle workflows, and process patient balances to maintain steady claim throughput.
• Customer Communication:
  Manage inbound and outbound phone calls, professionally explaining balances due, coverage details, and payment options to patients.
• Claims & Collections:
  Review flight and transport documentation, secure required coverage details, submit clean claims, and collect patient copays and outstanding balances.
• Technology & Platform Use:
  Utilize billing platforms to accurately log account activity, track claim status, and resolve balance inquiries.
• Compliance & Quality:
  Adhere to national EMS compliance guidelines, HIPAA rules, and company standards to ensure high-quality, accurate billing.
• Claim Denial and Appeals:
  • Analyze medical necessity denials, out-of-network rejections to identify root causes and patterns.
  • Draft, assemble, and submit formal, evidence-based appeals to commercial and government payers with necessary medical documentation and flight logs.
  • Track appeal deadlines and status via payer portals, following up regularly to secure overturns and proper claim reprocessing.
• Independent Dispute Resolution (IDR):
  • Identify, prepare, and initiate eligible out-of-network air medical claims for the federal No Surprises Act (NSA) Independent Dispute Resolution (IDR) process.
  • Manage the end-to-end IDR portal workflow, monitor arbitrator selections and binding determinations, and ensure final awarded payments are properly posted.

Qualifications & Details:

• Education & Experience:
  
  1 year of Air Medical billing, Medical billing or EMS billing experience is required.