Billing & Authorization Specialist

The Billing & Authorization Specialist ensures accurate and timely processing of EMS and Transfer related authorizations, billing, and records management to support patient care and organizational compliance. This role is responsible for managing pre-certification and prior authorization processes, resolving denied claims, and auditing transportation invoices to verify service levels, insurance coverage, and medical necessity. The specialist also oversees EMS agency billing activities, coordinates with internal departments and external vendors, and serves as the department’s Keeper of the Records. Position Responsibilities include preparing, verifying, submitting, registering and managing the pre-certification and/or prior authorization process for all applicable patient encounters and directly managing denied claims working with insurance companies. Reviews, audits and reconciles EMS agency invoices, Medicaid trips and prepares requisitions for payment, coordinating with Billing Manager, legal office, Accounts Payable and Purchasing. Functions as Department “Keeper of the Records” and interacts with internal HIM and legal staff.