Revenue Cycle QA Specialist — Audit & Process Improvement

Emergicon,-LLC-1; Terrell (TX); Hybrid; USD 65,000 - 92,000; Full time

Benefits offered by this job

Health insurance

Dental

Vision

401(k) retirement plan

Life insurance

Short-term disability

Critical illness coverage

Job summary

Emergicon LLC, based in Terrell, TX, seeks a Revenue Cycle Quality Assurance Specialist to audit billing, coding, AR, and payments for accuracy and compliance. You will help build audit tools, scorecards, and standards for Emergicon’s growing QA program.

The ideal candidate has 3+ years in healthcare revenue cycle, with experience across Medicare/Medicaid and commercial payer types, and familiarity with billing systems. This hybrid role requires adherence to HIPAA and strong analytical skills.

Qualifications

• Associate degree in healthcare administration or related field required, or equivalent practical revenue cycle experience
• Minimum of three years of healthcare revenue cycle, medical billing, coding, accounts receivable, denial management, auditing, quality assurance, or compliance experience required
• Experience with end-to-end healthcare revenue cycle operations required
• Experience in healthcare billing or revenue cycle systems required
• Direct experience in revenue cycle quality assurance or auditing preferred
• EMS billing experience preferred
• Experience across Medicare, Medicaid, commercial, managed care, and self-pay accounts preferred
• Certifications such as CPMA, CPC, CRCR, CHC, CAC or comparable healthcare auditing, coding, or compliance certifications preferred

Responsibilities

• Perform audits of revenue cycle activity to ensure accuracy, timeliness, and compliance
• Audit full claim lifecycle including demographics, insurance eligibility, charge entry, claims, coding, denials, and AR
• Identify billing errors, missed charges, duplicate billing, preventable denials, and revenue leakage
• Conduct root-cause analysis to determine sources of errors
• Quantify the financial impact of audit findings and track corrective actions
• Maintain supporting documentation and follow-up audits to ensure issues are resolved
• Escalate significant or recurring compliance concerns to the Director of Compliance
• Develop QA reporting covering audit results, error rates, trends, and corrective actions
• Collaborate to develop or improve SOPs; maintain confidentiality of PHI
• Align with Emergicon’s core values and work standards

Skills

Analytical skills

Excel proficiency

Audit/revenue cycle

Root cause analysis

Automation/AI tooling

HIPAA privacy

Communication

Independence

Education

Associate degree

Healthcare auditing cert

EMS billing experience

Tools

Billing platform

Payer systems

Billing software

Clearinghouse systems

Job description

Emergicon LLC, based in Terrell, TX, seeks a Revenue Cycle Quality Assurance Specialist to audit billing, coding, AR, and payments for accuracy and compliance. You will help build audit tools, scorecards, and standards for Emergicon’s growing QA program.

The ideal candidate has 3+ years in healthcare revenue cycle, with experience across Medicare/Medicaid and commercial payer types, and familiarity with billing systems. This hybrid role requires adherence to HIPAA and strong analytical skills.