Billing Auditor

CareFlite•Irving, TX

8d•Onsite

About The Position

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.

Requirements

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.
Strong attention to detail, time-management skills, and accuracy in work product.

Nice To Haves

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).

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 CareFlite’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 CareFlite processes.
Maintain strict confidentiality of medical and financial information in accordance with HIPAA and CareFlite 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 CareFlite 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.