Revenue Cycle Quality Assurance Specialist

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 hardwork, 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 checkon 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.

• 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, denial sand 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
• Helpbuild 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
• Alignwith and adhere to Emergicon’s core values
• Perform other job-related duties as assigned

• Associate’sdegree in healthcare administration, business, or a related field required, or equivalent practical revenue cycle experience
• Minimumof 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…