Medical Billing - Quaity Assurance - Digitech - Remote

The Sarnova Family of companies includes Digitech Computer, Bound Tree Medical, Tri-anim Health Services, Cardio Partners, and Emergency Medical Products

Digitech is a leading provider of advanced billing and technology services to the EMS transport industry. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle. Digitech leverages its proprietary technology to offer fully outsourced services that maximize collections, protect compliance, and deliver results for clients.

Summary:

The QA Specialist plays a critical role in ensuring the accuracy, compliance, and quality of all Medicare and Medicaid claims before submission. In this high volume, detail driven position, the QA Specialist reviews patient care reports (PCRs), validates service levels and documentation, and confirms that all regulatory and payer specific requirements are met. This role requires clinical insight, exceptional attention to detail, and a commitment to maintaining the highest standards of billing integrity.

Essential Duties and Responsibilities:

• Perform detailed quality reviews of all Medicare/Medicaid claims after coding and before submission to ensure accuracy, compliance, and completeness
• Examine patient care reports (PCRs) to confirm documentation supports the billed level of service and adheres to payer rules and medical necessity standards
• Validate coding selections, including level of service assignments, mileage accuracy, and required clinical indicators
• Ensure documentation compliance with federal, state, and payer regulations, including signature requirements, narratives, interventions, and supporting details
• Verify claim readiness by ensuring all required documentation and attachments are present prior to releasing the claim
• Identify discrepancies or errors and take action to correct, escalate, or return claims to coders for further review
• Maintain high volume throughput while consistently meeting accuracy and productivity expectations.
• Collaborate with Coding, Billing, QA leadership, and other internal teams to resolve questions or clarify documentation issues
• Support continuous quality improvement by identifying trends, gaps, or training opportunities.
• Additional job duties as assigned

Skills/Experience Required:

• Education: High School Diploma or equivalent
• Clinical or medical background strongly preferred: LPN, RN, EMT, Paramedic, LNA, Medical Aide, or equivalent experience
• Strong understanding of medical terminology, EMS clinical documentation, and healthcare billing standards
• Ability to navigate and work efficiently across multiple computer programs simultaneously
• Must have reliable home internet with speeds of 15 Mbps or higher
• Must successfully complete a basic computer skills assessment prior to interview; typing test for speed and accuracy may also be required
• Excellent attention to detail, accuracy, and documentation review skills
• Strong time management skills with the ability to meet tight deadlines and maintain high productivity
• Ability to remain focused, organized, and productive in a remote, independent work environment
• Strong communication skills, both written and verbal, with professionalism and excellent judgment.
• Dependable, punctual, and comfortable asking questions or seeking clarification when needed
• Ability to remain calm and effective in a fast-paced, time sensitive workload environment
• Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment

Physical Requirements:

• Ability to talk, hear, and see clearly to read and interpret information
• Regular use of a computer, phone, and standard office equipment
• May be required to travel for business purposes
• Ability to secure confidential information
• Perform all duties in a professional environment free of noise or anything that would create a negative customer experience

Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential function of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Sarnova is an Equal Opportunity Employer. We offer a competitive salary, commensurate with experience, along with a comprehensive benefits package, including 401(k) Plan. EO/M/F/Veterans/Disabled. Our mission is to be the best partner for those who save and improve patients’ lives. Excellence in delivering upon our mission is dependent upon having a diverse team that is empowered to bring their full, authentic self to work each day. We strive to create a workplace that reflects the communities we serve, and we are passionate about creating an inclusive workplace that promotes and values diversity. #digitech