Billing Auditor
11 days ago
Irving
Job DescriptionCompany Description Company Description: CareFlite 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. CareFlite 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 CareFlite’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 CareFlite’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 CareFlite 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., • 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., • Participate in education initiatives, meetings, or targeted follow-ups to reinforce proper documentation practices., • 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., • 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 CareFlite processes., • 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 CareFlite in a courteous, professional manner with a positive customer service demeanor., • 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. Hours of Work • Completion of all required CareFlite remote onboarding and training programs., • Participation in ongoing compliance, HIPAA, and billing training as required. Physical Demands • Prolonged sitting, frequent use of computers, occasional reaching or lifting up to 20 pounds (e.g., documents, equipment)., • Must be able to set up and maintain a safe and ergonomic home workstation (desk, chair, monitor height, keyboard/mouse setup)., • Ability to perform computer-based tasks for extended periods without injury or strain., • Ability to use a computer and office equipment, with adequate lighting and minimal distractions in the home workspace., • Ability to use assistive technology if needed (screen readers, voice recognition, adaptive keyboards, etc.)., • Must have access to a quiet and well-lit workspace suitable for focused work and video/phone meetings., • Must maintain a stable and secure internet connection to complete work tasks efficiently., • Ability to manage multiple tasks independently, handle confidential information, and maintain focus in a remote environment., • Must demonstrate professional communication and resilience when addressing billing or documentation concerns., • Self-motivation and time management skills to work independently., • Ability to maintain professional communication virtually and handle confidential information responsibly., • Adaptability to changing priorities, systems, or processes in a remote environment.Qualifications Required Qualifications • Must be 18 years of age or older., • High school diploma or equivalent., • Prior EMS field experience (EMT or paramedic) or previous experience in ambulance pre-billing, EMS ePCR review, or emergency medical documentation auditing., • Proficient in computer systems, electronic data processing, and modern office practices., • Working knowledge of Medicare, Medicaid, and other public health plan billing requirements., • Strong understanding of medical terminology and basic medical documentation standards., • Ability to communicate clearly and professionally, both verbally and in writing., • Ability to manage multiple tasks, meet deadlines, and work effectively under pressure with minimal supervision., • Ability to maintain professionalism and composure when interacting with difficult, distressed, or frustrated individuals., • Commitment to maintaining confidentiality and compliance with HIPAA regulations., • Experience with EMS or ambulance billing systems., • Familiarity with ImageTrend, Ambulance Commander, or similar billing management/ePCR systems., • Experience with third-party payors, hospitals, or claims follow-up processes., • Ability to work effectively with diverse populations and across language barriers., • Prior EMS, clinical, or prehospital exposure (field or administrative). Additional Information All your information will be kept confidential according to EEO guidelines. The statements contained in this position description reflect the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered a detailed description of all the work requirements that may be inherent in the position.
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