Job Description

BETTER CULTURE. BETTER PAY. BETTER PEOPLE.

*The Local Sonoma County Ambulance Provider*

Administrative / Operations Support

Full Time - Onsite

LIFEwest Ambulance is seeking a friendly, communicative individual with an administrative and organization skillset to work with a growing ambulance company in the state of California.

Visit our website: lifewestambulance.com

As part of the LIFEwest Ambulance team, this individual would be focused more on administrative tasks and operational support. The LIFEwest administrative tasks are completing Patient Care Reports (PCRs), ICD-10-PCS forms, and CAD support. Other administrative and operational tasks as needed.

Job Summary:

LIFEwest Ambulance is currently seeking a highly motivated Claim Appeals Specialist to join our team onsite in Cotati, CA. This role focuses exclusively on managing and resolving denied or disputed claims through the appeals process with insurance companies and state agencies. Candidates can be new graduates or entry-level professionals eager to develop their skills in medical billing and claim appeals.

LIFEwest Ambulance is a premier provider of quality emergency and non-emergency ambulance transportation services in California. Headquartered in Santa Rosa, CA, LIFEwest Northern California has been serving Sonoma, Napa, and Marin Counties since 2018. Our services include basic life support, advanced life support, critical care transport, and 911 ALS emergency resources, including being the official EMS provider for the Sonoma Raceway. Our employee-driven culture emphasizes professionalism, compassion, and customer focus.

Location: Cotati, CA (Onsite)

Duties/Responsibilities:

· Initiate and manage claim appeals with private insurance carriers, Medicare, Medicaid, and other government payers.

· Prepare, submit, and track all appeal documentation ensuring compliance with payer requirements and deadlines.

· Collaborate with insurance companies to follow up on appeal status and advocate for claim payment.

· File appeals with state agencies when necessary, managing the process through to resolution.

· Analyze claim denials and underpayments to determine appropriate appeal strategies.

· Communicate effectively with internal teams and external parties to gather necessary information and expedite appeals.

· Maintain detailed records of appeals, outcomes, and correspondence.

· Utilize knowledge of EMS billing, medical terminology, ICD-10, CPT coding, and payer-specific regulations to support appeals.

· Navigate multiple computer systems and insurance portals to manage appeal workflows efficiently.

· Meet hard deadlines in a fast-paced, high-volume environment with accuracy and attention to detail.

Education and Experience:

· Experience with or willingness to learn medical billing and claim appeals, preferably within EMS or healthcare billing environments.

· Strong understanding or willingness to learn of insurance claims processes, payer guidelines, and appeals procedures.

· Excellent communication and negotiation skills.

· Detail-oriented with strong organizational abilities.

· Proficient in using billing software, insurance websites, and Microsoft Office tools.

Physical Requirements:

· Prolonged periods of sitting at a desk and working on a computer

· Must be able to lift 15 pounds at times

· Ability to stand, bend, stoop, sit, walk, twist and turn.

· Ability to lift up to 25 pounds occasionally.

· Ability to use a computer keyboard and calculator.

· Work environment is indoors, majority of the time is spent sitting at a desk.

SALARY RANGE:

The base range for this position is $22.00/hr - $24.00/hr. The actual base salary offered depends on a variety of factors, which may include, as applicable, the applicant’s qualifications for the position; years of relevant experience; specific and unique skills; level of education attained; certifications or other professional licenses held; other legitimate, non-discriminatory business factors specific to the position; and the geographic location in which the applicant lives and/or from which they will perform the job.

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