Medical Billing and Coding Associate

Title: Medical Billing and Coding Associate

Location: Madison, Wisconsin 

Hourly Rate: $23.50 - $28.50 per hour  

Employment Type: Full Time 

Benefits: Medical, Dental, and Vision (with company contribution), Paid Time Off, 401k

About Ryan Brothers Ambulance by DocGo:  
DocGo is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population health, remote patient monitoring, and ambulance services. DocGo disrupts the traditional four-wall healthcare system by providing high quality, highly affordable care to patients where and when they need it. DocGo's proprietary, AI-powered technology, logistics network, and dedicated field staff of over 5,000 certified health professionals elevate the quality of patient care and drive efficiencies for municipalities, hospital networks, and health insurance providers. With Mobile Health, DocGo empowers the full promise and potential of telehealth by facilitating healthcare treatment, in tandem with a remote physician, in the comfort of a patient's home or workplace. Together with DocGo's integrated Ryan Brothers Ambulance medical transport services, DocGo is bridging the gap between physical and virtual care. 

Responsibilities: 

• Partners with Operations to resolve issues surrounding unbilled claims, authorizations, Physician Certification Statements (PCSs), Patient Care Reports (PCRs), and insurance, and demographic capture issues 
• Effectively code and bill ambulance transportation claims 
• Responsible for escalating concerns regarding questionable paperwork to appropriate management 
• Contact payers to verify claim status via phone or web and follow up on unpaid claims 
• Process appeals on aged insurance claims/denials 
• Ability to analyze, identify and resolve issues which may cause payer payment delays 
• Identify and resolve claim edits through understanding of billing guidelines and payer requirements 
• Reconcile commercial and government accounts, ensuring CPT and diagnostic codes are accurate 
• Interpret terms for Managed Care, Commercial, Medicare, Medicaid and Workers' Compensation and No Fault when applicable 
• Review all EOBs for correct payment, deductible, adjustments, and denials 
• Determining the status of claims with the insurance company, if the claim meets contractual agreements or needs adjustment 
• Reconcile account balances, and verify payments are applied correctly 
• Maintain well aged accounts, promptly resolve, and resubmit denied unpaid claims in a timely and efficient manner 
• Follow up on appeals/corrected submitted claims 
• Review and correct billing errors, which require a strong knowledge of CPT and ICD-10 coding 
• Review and audit customer service account inquiries 
• Receive inbound/outbound customer service call 
• Perform internal recovery calls and manage well aged self-pay accounts 
• Provide excellent customer service to all patients, Insurances & Facilities 
• Review and correct all rejections in clearing house 
• Perform all other related duties as assigned 

Qualifications: 

• Medical billing experience preferred, but not required
• Ambulance billing experience (preferred) 
• Extensive Medicare and Medicaid experience and understanding medical necessity in ambulance transportation 
• Proficient in CPT and ICD-10 coding 
• Ambulance/Medical billing certification or diploma preferred 
• Certified Ambulance Coder (CAC) certification required within 30 days of employment (company sponsored) 

EEO/AAP Statement:  DocGo is an equal opportunity employer. We acknowledge and honor the fundamental value and dignity of all individuals. We pledge ourselves to crafting and maintaining an environment that respects diverse traditions, heritages, and experiences.  DocGo is an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

The above-noted job description is not intended to describe, in detail, the multitude of tasks that may be assigned but rather to give the applicant a general sense of the responsibilities and expectations of this position.  As the nature of business demands change so, too, may the essential functions of the position.