Quality Assurance Representative

At Falck US, Revenue Cycle Management is not just numbers - it is part of how we help people after some of the most stressful moments in their lives. When we handle records, balances and questions clearly and respectfully, we make it easier for patients, payors and our colleagues in Operations, Insurance Relations and Patient Experience to do the right thing.

"Bring Care into your Career"

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This role is based in Santa Fe Springs Monday- Friday (7-4)

Hourly rate: $22-24 (DOE)

What We Offer:
• Full-Time Benefits (Medical, Dental, Vision, Life)
• 401(k) with company match
• Training and Career Development
• Generous Paid Time-Off

Patient Navigation Specialist

The Patient Navigation Specialist serves as a vital champion for our patients, acting as the critical link between field operations, clinical quality, and Revenue Cycle Management (RCM). This role is dedicated to ensuring a seamless, positive, and patient-centered experience from the moment of transport to the final resolution of a patient's account.

This is achieved by fostering strong operational collaboration , delivering impactful crew education , and building trusted facility relationships . The Patient Navigation Specialist proactively resolves issues, ensures the highest degree of documentation accuracy to prevent patient stress, and advocates for patient needs throughout the organization.

Key Responsibilities

Patient Advocacy & Experience

• Act as the primary local contact for patient-related inquiries, concerns, and feedback, providing support and resolution with a compassionate, patient-first mindset.
• Manage local patient outreach initiatives, including monitoring online reviews and collecting direct patient feedback to identify trends and areas for improvement.
• Proactively identify and resolve potential issues that could negatively impact the patient experience.
• Assist in developing educational materials that help patients understand the transport and billing process

Operational Collaboration & Crew Education

• Serve as the key liaison between local ambulance operations teams and the RCM department, bridging communication gaps and aligning processes to better serve the patient and field crews.
• Provide continuous training, reinforcement, and support to field crews on documentation standards and best practices, emphasizing how accurate reporting is vital for both quality patient care and a smooth billing journey.
• Work directly with crews and operations managers through ride-alongs, educational workshops, and other field-based events to provide hands-on support.
• Collaborate closely with the Training, Clinical, and Dispatch departments to ensure a cohesive and positive patient experience at every touchpoint.

Healthcare Facility & Partner Relationships

• Develop, foster, and maintain strong working relationships with staff at local hospitals, skilled nursing facilities, and other healthcare partners.
• Facilitate efficient communication with facilities to ensure the timely retrieval of necessary patient information (e.g.,face sheets, Prior Authorizations) required for accurate and prompt billing.
• Act as a professional representative of Falck when interacting with external partners and agencies.

Documentation Integrity & Quality Improvement

• Ensure the integrity of patient care records by support daily reconciliations to see that all electronic Patient Care Reports (ePCRs) are complete and accounted for.
• Conduct detailed reviews and audits of ePCRs to guarantee accuracy, which is vital for preventing billing errors and delays for the patient.
• Proactively obtain necessary addendums and corrections from field crews and clinical managers to prevent downstream issues that could negatively impact patients.
• Track and report on key metrics related to patient satisfaction/complaints, documentation quality, and feedback trends to drive continuous improvement initiatives.
• Attend Quality Improvement (QI) meetings if required and report on quality findings as needed.
• Willingness to gain necessary Certifications and education as needed

Qualifications & Requirements

• Experience: A minimum of two years of experience in a related field such as medical billing, healthcare patient advocacy, or ambulance operations is required.
• Patient-First Mindset: Must possess a genuine passion for patient advocacy and customer service.
• Skills & Competencies:
• Exceptional interpersonal, written, and oral communication skills, with an ability to educate and influence with professionalism and empathy.
• Strong organizational, analytical, and problem-solving skills with a keen attention to detail.
• Proven ability to work independently, manage multiple tasks, and prioritize effectively in a dynamic environment.
• A collaborative spirit with a demonstrated ability to build strong working relationships across different teams and with external partners.
• Proficient in Microsoft Office Suite (Word, Excel). Experience with ePCR software and medical billing systems is a strong plus.

Knowledge:

• A strong understanding of medical terminology and ambulance service levels (BLS, ALS, CCT) is highly desirable.
• Familiarity with insurance, medical necessity guidelines (e.g., Medicare/Medicaid), and the revenue cycle process is preferred.

This job description is a summary of duties, it is by no means an all-inclusive list but is merely a broad guide of expected duties.

Falck is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to race, color, religion, sex, gender identity, pregnancy, national origin, ancestry, citizenship, age, marital status, disability, sexual orientation, genetic information, veteran status or any other characteristic protected by state or federal law.