Founded 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 RESPONSIBILITIES
- Perform routine, random, targeted, and risk-based audits of revenue cycle activity, reviewing accounts for accuracy, completeness, timeliness, documentation, and adherence to established requirements
- Audit 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 notes
- Identify billing errors, missed charges, duplicate billing, preventable denials, incorrect adjustments, underpayments, revenue leakage, and other quality concerns — and the patterns and recurring issues behind them
- Conduct root-cause analysis to determine whether errors result from employee performance, training, processes, systems, payer requirements, or inadequate controls
- Quantify the financial impact of audit findings where appropriate
- Maintain accurate supporting documentation for audit findings, track corrective actions, and conduct follow-up audits to confirm issues stay resolved
- Escalate significant, recurring, or potential compliance concerns to the Director of Compliance promptly
- Develop and maintain quality assurance reporting covering audit results, error rates, recurring findings, trends, financial impact, and corrective actions
- Communicate findings clearly and objectively, distinguishing individual performance issues from training gaps, process deficiencies, system issues, and compliance concerns
- Help build and standardize Emergicon’s revenue cycle quality assurance program, including audit tools, scorecards, sampling methods, and written procedures
- Review 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 information
- Align with and adhere to Emergicon’s core values
- Perform other job-related duties as assigned
EDUCATION AND EXPERIENCE
- Associate’s degree in healthcare administration, business, or a related field required, or equivalent practical revenue cycle experience
- Minimum of three (3) years of healthcare revenue cycle, medical billing, coding, accounts receivable, denial management, auditing, quality assurance, or compliance experience required
- Demonstrated working knowledge of end-to-end healthcare revenue cycle operations required
- Experience working in healthcare billing or revenue cycle systems required
- Direct experience in revenue cycle quality assurance or auditing preferred
- EMS or ambulance billing (or other emergency-services healthcare billing) experience preferred
- Experience across Medicare, Medicaid, commercial, managed care, and self-pay accounts preferred
- CPMA, CPC, CRCR, CHC, CAC, or comparable healthcare auditing, coding, or compliance certification preferred
KNOWLEDGE, SKILLS, AND ABILITIES
- Strong analytical and investigative skills, including sampling, trend identification, root-cause analysis, and quantifying financial impact
- Proficiency in Microsoft Excel, including large data sets, lookups, and pivot tables
- Ability to learn and audit within Emergicon’s billing platform and related payer and clearinghouse systems
- Ability to design practical audit tools, scorecards, and error classifications that employees and leadership can understand and use
- Comfort adopting automation and AI-assisted tools that streamline audit and reporting work
- Alert to billing, documentation, payer, and compliance risks, and quick to recognize emerging trends
- Curious — asks why errors happen and investigates root causes rather than stopping at the error
- Responsive — acts promptly on significant findings and communicates clearly with the right stakeholders
- Objective and consistent, applying documented audit criteria while staying independent from the teams being audited
- Strong discretion with protected health information and confidential company information
WORKING CONDITIONS
This 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