Qureos Mentor

Empress Emergency Medical Services

<div>
 Apply Now
 
 
 <ul>
 <li>
 Job Title
 
 
 </li>
 </ul>
 Sr Medicare Biller
 
 
 <ul>
 <li>
 Location
 
 
 </li>
 </ul>
 Yonkers, NY
 
 
 <ul>
 <li>
 Department
 
 
 </li>
 </ul>
 Billing
 
 
 <ul>
 <li>
 FLSA Status
 
 
 </li>
 </ul>
 Exempt
 
 
 <ul>
 <li>
 Reports To
 
 
 </li>
 </ul>
 Jahaira Gomez
 
 
 <ul>
 <li>
 Shifts Hiring
 
 
 </li>
 </ul>
 Full-time
 
 
 <ul>
 <li>
 Pay Grade
 
 
 </li>
 </ul>
 63,700/Per Year
 
 
 
 Position Summary
 
 
 
 The Senior Medicare Biller is responsible for overseeing and managing Medicare billing processes for ambulance transports in compliance with federal, state, and payer-specific regulations. This role requires advanced knowledge of Medicare ambulance billing, New York State Medicaid coordination, documentation requirements, and appeals processes. The Senior Medicare Biller serves as a subject matter expert and ensures timely and accurate reimbursement while maintaining compliance with all regulatory standards.
 
 
 
 Key Responsibilities
 
 
 
 <ul>
 <li>
 Process, review, and submit Medicare claims for emergency and non-emergency ambulance services in accordance with CMS and New York State regulations
 </li>
 <li>
 Ensure accurate coding, modifiers, mileage, and level-of-service billing (BLS, ALS1, ALS2, SCT)
 </li>
 <li>
 Review documentation for medical necessity, physician certification statements (PCS), trip reports, and supporting records
 </li>
 <li>
 Identify, research, and resolve Medicare denials, underpayments, and rejections
 </li>
 <li>
 Prepare and submit redetermination, reconsiderations, and higher-level appeals as needed
 </li>
 <li>
 Coordinate Medicare crossover claims to New York State Medicaid and other secondary insurers
 </li>
 <li>
 Maintain compliance with CMS guidelines, OIG standards, HIPAA, and company policies
 </li>
 <li>
 Monitor aging reports, follow up on unpaid or delayed claims, and ensure timely resolution
 </li>
 <li>
 Act as a resource and mentor to billing staff, providing training and guidance on Medicare-related issues
 </li>
 <li>
 Assist with audits, compliance reviews, and internal quality assurance initiatives
 </li>
 <li>
 Communicate effectively with Medicare Administrative Contractors (MACs), Medicaid, and internal departments
 </li>
 <li>
 Stay current on Medicare policy updates, fee schedule changes, and regulatory requirements
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Minimum of 3&ndash;5 years of Medicare ambulance billing experience required
 </li>
 <li>
 In-depth knowledge of CMS ambulance billing regulations and New York State billing practices
 </li>
 <li>
 Strong understanding of medical necessity requirements and documentation standards
 </li>
 <li>
 Experience with Medicare appeals and denial resolution
 </li>
 <li>
 Proficiency with ambulance billing software and electronic claim submission systems
 </li>
 <li>
 High attention to detail and strong analytical skills
 </li>
 <li>
 Ability to prioritize workload and meet deadlines in a fast-paced environment
 </li>
 <li>
 Excellent written and verbal communication skills
 </li>
 <li>
 Ability to maintain confidentiality and compliance with HIPAA regulations
 
 
 </li>
 </ul>
 
 Preferred Qualifications
 
 
 
 <ul>
 <li>
 Experience with New York State Medicaid, No-Fault, and Workers&rsquo; Compensation coordination
 </li>
 <li>
 Prior supervisory or lead billing experience
 </li>
 <li>
 Familiarity with compliance audits and payer reviews
 </li>
 <li>
 CAC, CPC, CPB, or other relevant billing/coding certification
 
 
 </li>
 </ul>
 
 Work Environment
 
 
 
 <ul>
 <li>
 Office-based or hybrid role depending on company needs
 </li>
 <li>
 Fast-paced EMS billing environment with high-volume claim processing
 
 
 </li>
 </ul>
 
 Click Here To Review The Complete Job Description
 
 
 
 Apply Now
</div>

Sr Medicare Biller

Join Empress Emergency Medical Services and explore 1   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Empress Emergency Medical Services

About Company

Sr Medicare Biller