Billing Auditor

Company Description

Company

Description:

Care Flite is a 501(c)(3) nonprofit ambulance service sponsored by Baylor Scott & White Health, JPS Health Network, Methodist Health System, Parkland, and Texas Health Resources. Care Flite provides medical transport by helicopter, airplane, and ground ambulance, and non-medical transport via wheelchair van.

Job Description

Position Summary

The Billing Auditor plays a critical role in ensuring the accuracy, completeness, and compliance of all patient care documentation prior to billing. This position requires strong analytical ability, independent judgment, and exceptional attention to detail when reviewing electronic Patient Care Records (ePCRs), Physician Certification Statements (PCS), face sheets, and related documentation.

A core responsibility of this role is the continuous improvement of PCR quality. The Billing Auditor ensures each record meets payer, regulatory, and internal standards before submission to Care Flite's third-party billing partner.

Equally essential is the maintaining strong, collaborative relationships with ground crews by providing clarification, education, and real-time support to reinforce the importance of accurate billing documentation and its direct impact on Care Flite's mission, patient advocacy standards, and documentation integrity.

The Billing Auditor serves as a key link between field operations, the Integrated Billing Services team, and external billing partners. This position ensures compliance with Medicare, Medicaid, commercial insurance requirements, HIPAA, state EMS regulations, and Care Flite policies, while supporting audits, reporting, and departmental process-improvement initiatives.

Key Responsibilities

Documentation Review & Pre-Billing Audits

• Review daily ePCRs and associated documentation to ensure accuracy, completeness, compliance, and readiness for billing.
• Conduct pre-billing audits and return PCRs to crews for correction or clarification as necessary.
• Identify documentation trends affecting billing performance and communicate findings to Integrated Billing Services leadership.
• Review PCS forms, face sheets, signatures, mileage, and all documentation required for compliant EMS claims.

Crew Engagement & Support

• Communicate daily with crew members who have pending, missing, or incomplete PCRs to ensure timely completion before the end of their shift.

• Assist crews with documentation or billing questions and provide clarification on payer requirements and documentation standards.
• Build and maintain positive relationships with crews to promote Care Flite's mission, standards

of patient advocacy, operational excellence, and documentation integrity.

• Participate in education initiatives, meetings, or targeted follow-ups to reinforce proper documentation practices.
• Provide feedback to assist in the development and refinement of documentation training materials, policies, and crew education initiatives.

Billing Cycle Support & Departmental Assistance

• Obtain, scan, and attach required documents to the ePCR or billing software when not automatically linked.
• Support the Integrated Billing Services Manager, Billing Coordinator, and Custodian of Records with departmental needs as required.
• Document audit activities, findings, and communication per departmental procedures.

Compliance & Regulatory Requirements

• Ensure adherence to federal, state, and organizational billing procedures, including Medicare, Medicaid, commercial payor requirements, and HIPAA.
• Maintain working knowledge of ambulance billing regulations, state EMS rules (including TAC 157), and internal Care Flite processes.
• Maintain strict confidentiality of medical and financial information in accordance with HIPAA and Care Flite policies.

Professionalism & Administrative Duties

• Communicate professionally and respectfully with internal staff, field crews, external partners, healthcare facilities, and third-party billing entities.
• Demonstrate regular attendance, punctuality, and the ability to perform duties independently.
• Attend at least 75% of quarterly staff meetings.
• Represent Care Flite in a courteous, professional manner with a positive customer service demeanor.
• Perform other duties as assigned while contributing to a respectful and collaborative work environment.

Core Competencies

• Teamwork: Collaborates effectively with departments, field crews, and leadership to support accurate billing processes.
• Communication: Communicates clearly, respectfully, and professionally with internal and external stakeholders.
• Problem Solving: Applies critical thinking and resourcefulness to resolve documentation discrepancies.
• Integrity: Maintains confidentiality and adheres to organizational policies and ethical standards.
• Patient Focus: Demonstrates a commitment to accuracy and timeliness in documentation to support patient billing needs.

Working Conditions

Hours of Work

• Hourly position: hours vary based on business needs.

Overtime Expectations

• Overtime may be required as needed to meet departmental deadlines or…