Job Summary

The Revenue Cycle Specialist - Air is responsible for reviewing, resolving, and processing Air client claims throughout the revenue cycle in a timely, accurate, and compliant manner. This role performs proactive payer follow-up, resolves pending, denied, underpaid, and aged claims, and addresses account barriers to maximize reimbursement and minimize revenue loss. The Revenue Cycle Specialist – Air collaborates with internal and external partners, identifies payer and account trends, and supports continuous improvement while meeting operational performance standards and client service commitments.

Major Responsibilities/Activities

• Monitor assigned Air client accounts and claim inventories to identify revenue risks, reimbursement delays, aging trends, and opportunities to improve performance.
• Prioritize and resolve pending, rejected, denied, underpaid, stalled, and aged claims—including accounts over 120 days—in accordance with payer requirements, client specifications, compliance standards, service-level agreements, and leadership direction.
• Manage claims across assigned payer categories, including commercial insurance, TRICARE, workers’ compensation, VA, Medicare, Medicaid, and other government-funded programs.
• Contact payers and use approved portals to verify claim status, eligibility, benefits, payment details, filing requirements, and additional actions or information needed for resolution.
• Obtain medical records and other supporting documentation, engaging patients or authorized parties when appropriate to advance pending or denied claims.
• Prepare and submit claim corrections, reconsiderations, and appeals, including verbal appeals when appropriate, and document all actions accurately and completely.
• Research underpayments, overpayments, payment discrepancies, and remaining balances; determine the appropriate resolution and prepare refund documentation for leadership approval when required.
• Identify account issues and root causes, take appropriate action within established authority, follow matters through completion, and escalate complex or unresolved issues with clear supporting information.
• Monitor client outcomes against established commitments, productivity and quality standards, operating procedures, and service-level agreements; communicate payer trends, recurring deficiencies, workflow barriers, client concerns, and improvement opportunities to operational and management teams.
• Collaborate with onshore and offshore team members and cross-functional revenue cycle partners to support accurate account handling, effective prioritization, and timely reimbursement.
• Maintain current knowledge of payer policies, prompt-payment requirements, regulatory changes, and Air client-specific procedures while delivering professional service and maintaining constructive relationships with payers, clients, patients, leaders, and colleagues.
• Perform other duties as assigned.

Required Education, Skills, & Experience

• High school diploma or equivalent.
• One to two (1-2) years of experience in medical billing, insurance follow-up, denials management, healthcare accounts receivable, or claim resolution; one (1) year of EMS billing experience may substitute for the broader experience requirement. 
• Working knowledge of healthcare revenue cycle processes, insurance benefits, payer types, claim status follow-up, denials, underpayments, correspondence, and appeals.
• Ability to learn, interpret, and apply payer requirements, client procedures, compliance standards, prompt-payment guidelines, and filing and appeal deadlines.
• Working knowledge of HIPAA requirements and demonstrated ability to protect confidential patient and client information.
• Strong analytical, critical-thinking, and problem-solving skills, with sound judgment to resolve issues within established authority and escalate when appropriate.
• Strong attention to detail, including the ability to document account activity clearly, accurately, and completely.
• Strong organizational and time-management skills, with the ability to prioritize multiple work queues and deadlines while meeting productivity, quality, and turnaround-time expectations.
• Effective written and verbal communication and customer-service skills for interacting professionally with payers, patients, clients, leaders, and colleagues.
• Ability to work independently and collaboratively with cross-functional, onshore, and offshore teams and to adapt to changing payer requirements, client needs, systems, procedures, priorities, and responsibilities.
• Proficiency with Microsoft Office applications and the ability to navigate billing systems, document-management tools, payer portals, and multiple applications efficiently. 
• Proficiency in English is necessary for job-related communication, including understanding policies, writing correspondence, and engaging with colleagues or clients.

Preferred Education, Skills, & Experience

• Experience supporting air medical, emergency medical services, ambulance billing, or another complex healthcare revenue cycle environment.
• Experience with commercial insurance, TRICARE, workers' compensation, VA, Medicare, Medicaid, or other government payer claim follow-up.
• Experience with medical insurance collections, denials, appeals, medical terminology, and aged accounts.
• Proficiency in EMS|MC billing software or a comparable ambulance billing platform.

Working Environment

• The office environment is a controlled indoor setting with minimal exposure to adverse conditions. 
• Noise levels in the office are typically moderate and consistent with a standard office setting. 
• For employees approved to work in a hybrid or remote setting, a quiet, private workspace free from significant distractions is required to ensure productivity during work hours. 
• A reliable internet connection is required for hybrid/remote work. EMS|MC will provide necessary equipment, including a computer, monitor, keyboard, mouse, and headset. 

Physical Requirements:

• Sitting: frequent and prolonged periods of sitting at a desk while working on a computer. 
• Communication: frequent and prolonged periods of speaking, listening, reading, and writing. 
• Fine motor skills: frequent use of hands for typing and operating a computer mouse.  
• Movement: occasional walking and climbing of stairs; limited bending, kneeling, lifting, and carrying of office-related items.  

Pay range: $20.00 - $25.00 an hour with final compensation based on the candidate’s qualifications, experience, and business needs. Individuals in this role are eligible to participate in a discretionary bonus plan and a comprehensive benefit package, including a retirement plan, health coverage, paid time off and other benefits provided in accordance with applicable law. Visit https://emsmc.com/careers/ to explore our total rewards package. 

Employees must be able to perform the essential functions of this position. Reasonable accommodations will be provided to qualified individuals with disabilities as needed to support their ability to perform these essential functions. If you require an accommodation for this position or to participate in the application process, please contact HR at humanresources@emsmc.com.

The responsibilities and duties outlined in this job description are not exhaustive and may be subject to change to meet the needs of the business. This job description is not an implied contract of employment and does not alter the at-will employment relationship.

There is no anticipated closing date for applications; The role will remain open until filled.

Applicants must be authorized to work in the United States now and in the future; this role does not offer current or future visa sponsorship.