About this opportunity
Emergicon LLC lists this Revenue Cycle Quality Assurance Specialist opportunity in terrell, Texas. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Revenue Cycle Quality Assurance SpecialistFounded in 2006, Emergicon has grown into the largest emergency medical billing company in Texas, serving fire departments and EMS agencies ranging from small rural operations to major Texas cities. Emergicon and Emergifire operate from a "service-first" culture built on hard work, accountability, and kindness.We are looking for an experienced Revenue Cycle Quality Assurance Specialist to join our compliance team. In this role, you'll serve as Emergicon's dedicated quality check on the revenue cycle — auditing billing, coding, accounts receivable, and payment activity for accuracy, completeness, and compliance, then tracking corrective action until problems stay fixed. This position also helps build the audit tools, scorecards, and standards for Emergicon's growing quality assurance program.This is a hybrid position based out of our Terrell, TX office, with remote work available in accordance with company policy.Essential Duties And ResponsibilitiesPerform routine, random, targeted, and risk-based audits of revenue cycle activity, reviewing accounts for accuracy, completeness, timeliness, documentation, and adherence to established requirementsAudit across the full claim lifecycle, including patient demographics, insurance and eligibility, charge entry, claims, coding and documentation, denials and appeals, accounts receivable follow-up, payment posting, adjustments, write-offs, credits, refunds, and account notesIdentify billing errors, missed charges, duplicate billing, preventable denials, incorrect adjustments, underpayments, revenue leakage, and other quality concerns — and the patterns and recurring issues behind themConduct root-cause analysis to determine whether errors result from employee performance, training, processes, systems, payer requirements, or inadequate controlsQuantify the financial impact of audit findings where appropriateMaintain accurate supporting documentation for audit findings, track corrective actions, and conduct follow-up audits to confirm issues stay resolvedEscalate significant, recurring, or potential compliance concerns to the Director of Compliance promptlyDevelop and maintain quality assurance reporting covering audit results, error rates, recurring findings, trends, financial impact, and corrective actionsCommunicate findings clearly and objectively, distinguishing individual performance issues from training gaps, process deficiencies, system issues, and compliance concernsHelp build and standardize Emergicon's revenue cycle quality assurance program, including audit tools, scorecards, sampling methods, and written proceduresReview current workflows and collaborate with revenue cycle leadership and subject-matter experts to develop or improve standard operating procedures (SOPs)Maintain confidentiality and objectivity throughout the audit process, and safeguard protected health information and company financial informationAlign with and adhere to Emergicon's core valuesPerform other job-related duties as assignedEducation And ExperienceAssociate's degree in healthcare administration, business, or a related field required, or equivalent practical revenue cycle experienceMinimum of three (3) years of healthcare revenue cycle, medical billing, coding, accounts receivable, denial management, auditing, quality assurance, or compliance experience requiredDemonstrated working knowledge of end-to-end healthcare revenue cycle operations requiredExperience working in healthcare billing or revenue cycle systems requiredDirect experience in revenue cycle quality assurance or auditing preferredEMS or ambulance billing (or other emergency-services healthcare billing) experience preferredExperience across Medicare, Medicaid, commercial, managed care, and self-pay accounts preferredCPMA, CPC, CRCR, CHC, CAC, or comparable healthcare auditing, coding, or compliance certification preferredKnowledge, Skills, And AbilitiesStrong analytical and investigative skills, including sampling, trend identification, root-cause analysis, and quantifying financial impactProficiency in Microsoft Excel, including large data sets, lookups, and pivot tablesAbility to learn and audit within Emergicon's billing platform and related payer and clearinghouse systemsAbility to design practical audit tools, scorecards, and error classifications that employees and leadership can understand and useComfort adopting automation and AI-assisted tools that streamline audit and reporting workAlert to billing, documentation, payer, and compliance risks, and quick to recognize emerging trendsCurious — asks why errors happen and investigates root causes rather than stopping at the errorResponsive — acts promptly on significant findings and communicates clearly with the right stakeholdersObjective and consistent, applying documented audit criteria while staying independent from the teams being auditedStrong discretion with protected health information and confidential company informationWorking ConditionsThis position involves extended periods of sitting or standing at a desk while working on a computer. Work is hybrid, splitting time between Emergicon's Terrell, TX office and a remote environment that supports the safe handling of confidential financial and protected health information.Benefits: Emergicon invests in its people with a full benefits package: health insurance, dental, vision, life insurance, 401(k) retirement plan, and short-term disability and critical illness coverage.Offer of position is contingent on passing a pre-employment background check and drug screening.With a close-knit "One Team. One Sound." culture, Emergicon offers real room to grow for people who want to make an impact in the EMS industry.Emergicon LLC is an EEO Employer - M/F/Disability/Protected Veteran Status
Worksite address
terrell, TX, 75160, US
Who can apply
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