EMS Billing & Compliance Lead

Wake County; Raleigh (NC); Vor Ort; USD 95.000 - 128.000; Vollzeit

Zusammenfassung

Wake County EMS is seeking a billing/audit professional to review patient care reports and claims for medical necessity. The role focuses on compliance, audits, and reporting, with responsibility for addressing denials, monitoring high-value codes, and working with the billing vendor to implement fixes.

You will lead annual risk assessments, update policies, and deliver training on documentation, billing and privacy. The position supports OSHA compliance and may involve safety investigations.

Qualifikationen

• Associate's degree in Public Safety, Healthcare, Management or related field.
• Five Years of Public Safety or Military Experience is also required in the baseline qualifications.

Aufgaben

• Audit EMS billing and coding from the patient care report to the claim, including whether the care billed was medically necessary.
• Watch the billing data (denials, high-value codes, outliers), build billing compliance metrics and brief leadership on what they show.
• Hold our billing vendor accountable and report what you find.
• When an audit finds a problem, lead the response: investigate, find the root cause, make sure overpayments are repaid on time, and fix the process.
• Run our annual compliance risk assessment and keep the EMS risk register current, including billing and HIPAA privacy risks.
• Keep policies current, deliver training on documentation, billing, and privacy, and keep reporting channels open for people who speak up.
• Support OSHA compliance, injury prevention and safety incident investigations
• Step into the Emergency Operations Center or operational safety officer role during major events

Kenntnisse

Billing & Coding

Auditing

Compliance

HIPAA Privacy

OSHA Compliance

Training & Documentation

Ausbildung

Associate's degree in Public Safety, Healthcare, Management or related field

Jobbeschreibung

Wake County EMS is seeking a billing/audit professional to review patient care reports and claims for medical necessity. The role focuses on compliance, audits, and reporting, with responsibility for addressing denials, monitoring high-value codes, and working with the billing vendor to implement fixes.

You will lead annual risk assessments, update policies, and deliver training on documentation, billing and privacy. The position supports OSHA compliance and may involve safety investigations.