EMS Documentation & Pre-Authorization Specialist

Central-Ems; Conyers (GA); On-site; USD 52,000 - 68,000; Full time

Job summary

Central-Ems is seeking an Insurance Pre-Authorization & DQA Specialist to ensure accurate prior authorizations for EMS transports and high-quality documentation in PCRs.

The role links field operations, billing, and compliance to support compliant reimbursement. A strong background in EMS billing, medical terminology, and CMS requirements is essential for success in a fast-paced, office-based environment.

Qualifications

• High school diploma or equivalent required.
• Associate degree in healthcare administration, billing/coding, or related field preferred.
• 1–2 years of experience in medical billing, insurance, or healthcare administration preferred.

Responsibilities

• Verify insurance eligibility, benefits, and coverage for EMS transports.
• Initiate and obtain prior authorizations for scheduled transports.
• Document communications, approvals, and denials in patient records/billing system.
• Follow up on pending authorizations to prevent denials.
• Review PCRs for accuracy, completeness, and compliance with CMS/state regulations.
• Provide feedback to field crews on documentation improvements.
• Maintain QA logs and reports; support audits and compliance reviews.

Skills

EMS operations knowledge

Medical terminology

CMS requirements

Attention to detail

Communication skills

ePCR/billing systems

Education

High school diploma or equivalent

Associate degree in healthcare administration, billing/coding, or related field

EMT or Paramedic certification

Tools

Billing software

ePCR systems

CMS portals

Job description

Central-Ems is seeking an Insurance Pre-Authorization & DQA Specialist to ensure accurate prior authorizations for EMS transports and high-quality documentation in PCRs.

The role links field operations, billing, and compliance to support compliant reimbursement. A strong background in EMS billing, medical terminology, and CMS requirements is essential for success in a fast-paced, office-based environment.