UR/Coding Lead

Job Locations US-Virtual / Remote
Customer Service/Support
Category 2


Under the direction and supervision of Revenue Cycle Management Supervisor / Manager/ Director; The Lead Position is directly responsible to supervise, assist, train, and provide support to CPC and CAC staff in all areas of Revenue Cycle Management daily operations.  Coordinates activities and schedules work assignments to meet billing deadlines. Familiar with a variety of medical billing/collection concepts, practices, and procedures. Relies on extensive experience and judgment to plan and accomplish goals.


Good working knowledge of HIPAA, HCPCS, CPT, ICD-10 codes. Ability to train and develop staff.  Must have excellent verbal and written communication skills.  Must have working knowledge of patient accounting functions, tools and processes applicable to medical claims.  Must be proficient in Microsoft Windows, Excel and Word, Adobe Acrobat.  Ability to quickly learn multiple operating systems; e.g., GH, and other patient accounting systems.  Ability to communicate with all levels. Superior attention to detail.



  1. Supervise, assist, train, and provide support to staff
  2. Provides daily directive to staff
  3. Assigns worklist as necessary
  4. Maintain client review process for coding related issues and provide feedback to manager and upper management
  5. Responsible for production review and production discussions with staff
  6. Tracks staff attendance and disciplinary measures when necessary
  7. Maintains and approves timecards
  8. Responsible for Jira creation and tracking employee access requests
  9. Responsible for maintaining all assigned customer accounts current
  10. Thorough knowledge of ICDs, HCPCS and CPT codes
  11. Thorough knowledge of Medicare Ambulance Services guidelines with applicability to:
  12. Crew and Vehicle Requirements
  13. Level of Service
  14. HCPCs
  15. Modifiers
  16. Local Coverage Determinations
  17. Mileage
  18. Signature Guidelines
  19. Coverage Guidelines for Air and Ground
    1. Destination
    2. Medical Reasonableness and Necessity
    3. Closer Appropriate Facility
    4. Exceptions to coverage guidelines
  20. Ability to interpret payer requirements related to ambulance billing
  21. Ability to provide comprehensive review and analysis of all aspects related to ambulance services and billing to support Compliance, Quality Assurance, the Revenue Cycle, and Process Improvement
  22. Assists in the development of Standard Operating Procedures and Processes, in collaboration with Compliance, Quality Assurance and RCM Leadership
  23. Ability to identify trending issues, related to ambulance billing, track, and report occurrences, and respond appropriately
  24. Collaborates with Compliance, Quality Assurance and RCM Leadership to educate Staff and Customers
  25. Provides on-going review and training to Staff
  26. Other duties as assigned




  1. Maintains presentable personal appearance.
  2. Ability to provide written communication using best business practices when composing letters, memorandums, and e-mails regardless if the communication is inside the Company or with customers, clients, or providers
  3. Is a team player and communicates well with employees.
  4. Maintains a high level of confidentiality.
  5. Demonstrates leadership by acting as a role model. Setting the standard and living it each day.  
  6. Supervisory responsibility.
  7. Ability to read, write and follow specific instructions in both written and verbal form.
  8. Must adhere to all Company safety, compliance, business ethics, and privacy regulations.
  9. Requires an in depth understand of compliance, regulatory oversight bodies and payer requirements.
  10. Initiative required to learn company organization and procedures.
  11. Represents the company in a positive, customer friendly attitude to other employees, clients, agencies, entities and patients.
  1. Good customer service skills
  2. Works well under pressure to meet deadlines
  3. Goal oriented to meet production, quality and budget standards
  4. Demonstrates understanding of full scope of responsibilities and uses discernment to prioritize continuously
  5. Makes decisions founded on data and facts
  6. Contributes to process improvements and efficiencies
  7. Strong interpersonal and communication skills with the ability to communicate at all levels
  8. Ability to read and understand an EOB
  9. Understands working in a team environment for the success of the team
  10. Ability to utilize PC using word, excel, custom billing software
  11. Ability to work in a production environment
  12. Experience in emergency medical services, medical dispatching, or patient registration will be helpful           






Requires a minimum of HS diploma or equivalent, AA preferred.   Must maintain current coding certificate CPC or Nursing degree.  5+ years specific ambulance billing/collections experience.  Strong familiarity and work experience utilizing resources and reference materials from the International Classification of Diseases 9th Edition, Clinical Modification (ICD-9-CM) any edition, updated to current year.  Current Procedural Terminology (CPT), any edition, updated to current year.  Good working knowledge of Microsoft Office, Word, Excel, PowerPoint on a medium to expert level. 


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