We are one of central and western Virginia's largest independent medical transportation providers — four bases, roughly 30 clinical vehicles, and 5,500 square miles of coverage serving the region's major health systems. We are now expanding beyond transport into in-home clinical care: hospital-at-home field visits and community paramedicine. Every dollar of that growth flows through revenue cycle, and we are hiring the person who will own it.
About the Role
You will be the owner of our billing and collections function across two revenue lines: our core ambulance and wheelchair transport business (Medicare, Virginia Medicaid and its managed care organizations, commercial payers, and facility contracts) and our growing in-home care business (per-visit invoicing to hospital partners today, direct Medicaid community paramedicine billing as Virginia's reimbursement framework comes online). Twelve months in, success looks like clean claims going out the door on time, days-in-AR trending down, denial rates falling, and billing workflows for our new home-care service lines built and running — not inherited, built by you.
What You'll Do
- Prepare, code, and submit ambulance and non-emergency medical transport claims — HCPCS base rates and mileage, origin/destination modifiers, ICD-10 coding, and medical necessity documentation — to Medicare, Virginia Medicaid/DMAS, Medicaid MCOs, and commercial payers.
- Manage prior authorizations and Physician Certification Statements (PCS) for repetitive and scheduled transports, working with facility case managers to keep documentation audit-ready.
- Own denials and appeals end to end: track root causes, work aging AR, resubmit corrected claims, and report denial trends to leadership monthly.
- Run facility contract invoicing for hospitals, skilled nursing facilities, and hospital-at-home partners — per-trip, per-visit, and dedicated-unit contract billing — and reconcile payments against contract terms.
- Post payments, reconcile ERAs/EOBs against deposits, and maintain accurate AR aging and cash-collections reporting.
- Build and document the billing workflow for our community paramedicine and in-home visit services as Virginia's DMAS reimbursement for these services is implemented — payer enrollment, coding conventions, and claim submission processes.
- Safeguard compliance with HIPAA, Medicare ambulance fee schedule rules, and payer documentation requirements; support internal and external audits.
What We're Looking For
Required:
- 3+ years of medical billing experience, including hands-on ambulance, EMS, or medical transportation billing.
- Working knowledge of the Medicare ambulance fee schedule, medical necessity rules, and Virginia Medicaid / MCO transport billing.
- Experience with billing software and clearinghouses (EMS billing platforms such as ESO, ZOLL Billing, Traumasoft, or comparable).
- A track record of reducing denials and working AR — you can walk us through a denial you overturned and why.
- High attention to detail with patient data and the judgment to escalate compliance concerns early.
Preferred:
- Certified Ambulance Coder (CAC) through NAAC, or CPB/CPC certification.
- Home health, hospital-at-home, or community paramedicine billing exposure.
- Experience standing up billing for a brand-new service line — payer enrollment through first paid claim.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
