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Scheduled Weekly Hours:

Work Shift:

Provides leadership and oversight for the EMS Transportation billing and revenue cycle operations, ensuring timely, accurate, compliant, and fiscally responsible billing and collection activities for ground and air medical transportation services. Directs and develops billing staff, establishes and monitors performance expectations, and partners with EMS operations, Revenue Cycle, Finance, payers, and other organizational stakeholders to optimize revenue realization, reduce accounts receivable, resolve billing and payer issues, and improve the overall patient financial experience. Responsible for the day-to-day management of EMS Transportation billing operations, including claim submission, payment posting, accounts receivable follow-up, denial and underpayment management, insurance verification and authorization processes, billing compliance, financial reconciliation, and reporting. Utilizes data and financial analytics to identify trends, develop corrective action plans, improve operational performance, and support strategic decision-making.

Essential Job Functions

• Provides leadership and oversight of EMS Transportation billing operations. Ensures daily billing activities are completed accurately and timely, including claim submission, payment posting, account follow-up, denial management, correspondence, adjustments, refunds, and account resolution.
• Manages and develops billing staff. Establishes performance expectations, monitors productivity and quality, conducts regular staff check-ins and evaluations, provides coaching and corrective action as appropriate, and promotes professional development and accountability.
• Develops and maintains billing training programs. Oversees orientation and training for new employees and provides continuing education related to EMS billing requirements, payer requirements, organizational policies, billing systems, regulatory changes, and revenue cycle processes.
• Monitors EMS Transportation revenue cycle performance. Develops, maintains, and analyzes key performance indicators, including point-of-service collections, days in accounts receivable, aging, cash collections, denial rates, clean claim rates, claim submission timeliness, payment variance, productivity, and other department-specific metrics.
• Coordinates insurance billing and accounts receivable management. Oversees insurance filing, claim status follow-up, payer correspondence, payment posting, account reconciliation, denial and rejection resolution, underpayment identification, and escalation of complex payer issues.
• Ensures accurate and timely financial reconciliation. Oversees daily deposits, payment posting, adjustments, refunds, and daily/monthly balancing activities. Coordinates monthly financial and compliance audits and investigates and resolves discrepancies.
• Partners with EMS operational leadership to improve financial performance. Uses financial and operational data to identify opportunities for improvement, develops action plans, and collaborates with operational and clerical teams to improve documentation, billing accuracy, charge capture, authorization processes, collection performance, and overall revenue cycle results.
• Monitors payer requirements and revenue cycle compliance. Maintains working knowledge of Medicare, Medicaid, commercial payer, and other applicable EMS transportation billing requirements. Ensures departmental processes are consistent with organizational policies, payer requirements, and applicable regulatory and compliance standards.
• Manages denial, rejection, and underpayment trends. Identifies recurring payer and billing issues, analyzes root causes, tracks financial impact, and coordinates appropriate corrective actions with billing staff, EMS operations, Revenue Cycle, Finance, and payer representatives.
• Supports the development and implementation of EMS Transportation billing processes and procedures. Identifies opportunities to streamline workflows, improve system utilization, reduce manual work, increase automation, and strengthen controls throughout the revenue cycle.
• Coordinates departmental staffing and scheduling. Develops and maintains staff schedules, coordinates coverage for time off and call-offs, monitors staffing needs, and balances staffing levels with operational demands while minimizing unnecessary overtime.
• Provides financial and operational reporting to leadership. Prepares and presents regular reports regarding billing performance, accounts receivable, collections, payer performance, denials, productivity, and other relevant financial and operational measures. Escalates significant trends, risks, and opportunities to appropriate leadership.
• Supports system and departmental projects. Participates in and/or leads projects involving billing systems, payer initiatives, process changes, revenue cycle improvements, technology implementations, and other initiatives affecting EMS Transportation billing operations.
• Serves as a resource and subject matter expert for EMS Transportation billing. Provides guidance to staff and operational leaders regarding billing requirements, payer issues, account resolution, documentation requirements, and revenue cycle processes.
• Promotes service excellence. Embraces organizational standards of behavior and promotes excellent customer service for patients, families, payers, EMS associates, providers, and other internal and external customers. Holds self and others accountable for behaviors that support a positive patient financial experience.
• Maintains appropriate controls and safeguards. Ensures billing, payment posting, adjustments, refunds, deposits, and other financial activities are performed in accordance with organizational policies and established internal controls.
• Perform other duties and responsibilities as assigned.
• This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.

Employment Qualifications

• Required Minimum Education: High School Diploma or GED
• Preferred Education: Bachelor's Degree
• Specialty/Major: Business, Healthcare Administration, Finance, Revenue Cycle Management, or a related field

Licensing/ Certification

• Licensure/Certification Required: Certified Ambulance Coder within 6 months of start date, or equivalent EMS billing certification as approved by the organization.
• Licensure/Certification Preferred: Certification or formal training in healthcare revenue cycle, medical billing, medical terminology, EMS billing/coding, or a related field.

Minimum Qualifications

• Minimum Years and Type of Experience: 3-5 years of experience in healthcare revenue cycle, medical billing, EMS billing, or a related healthcare financial environment. 2 or more years of supervisory or management experience preferred. Demonstrated experience with accounts receivable management, insurance billing, payer follow-up, denial management, and financial reconciliation. Experience working with billing systems and financial reporting tools.
• Other Knowledge, Skills and Abilities Required: Ability to lead/direct others; high degree of analytical ability; working knowledge of Microsoft Office.  Prior experience in healthcare billing operations.
• Other Knowledge, Skills and Abilities Preferred: Knowledge of registration, insurance, scheduling, and/or verification and hospital billing.  Prior experience in Air and Ground Medical Transportation billing and operations.

Mercy Health is an equal opportunity employer.

As a Mercy Health associate, you’re part of a Misson that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way. 

What we offer
•    Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
•    Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts
•    Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
•    Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.
 

Department:

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health– Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email [email protected]. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at [email protected].