Under the direction of the Communications Manager, the Dispatch DQA Representative coordinates the timely deployment and tracking of ambulance units while supporting the completeness, accuracy, and compliance of documentation required for patient care and billing. The representative receives and prioritizes service requests, communicates assignments and operational information to field crews, verifies patient demographics and insurance coverage, and reviews dispatch and clinical records to resolve documentation deficiencies before submission to the billing office.

Reports To

Communications Manager

Essential Duties and Responsibilities

• Receive caller information, determine the nature and priority of service requests, and dispatch emergent and non-emergent assignments accurately and promptly in accordance with Emergency Medical Dispatch protocols and the local System Status Management Plan.
• Monitor unit status, location, deployment, and movement throughout the shift; communicate assignments, emergencies, status changes, and general operational information by radio, telephone, and computer.
• Maintain accurate CAD records, including call types, priorities, timestamps, unit activity, and other pertinent information.
• Review PCRs, PCS forms, CAD records, patient demographics, insurance information, and supporting documents for completeness, consistency, accuracy, and billing readiness.
• Cross-reference PCRs with CAD data to confirm that each ambulance run has appropriate documentation and that identified discrepancies are corrected before submission.
• Verify insurance coverage, including Managed Care, Medicare, and Medicaid, and obtain missing demographic, authorization, or coverage information as needed.
• Communicate professionally with call takers, dispatchers, shift supervisors, drivers, EMTs, field supervisors, healthcare facilities, public safety agencies, insurance companies, billing staff, operations leaders, and other support personnel to resolve operational or documentation issues.
• Follow up on records in hold queues and address deficiencies involving insurance verification, patient demographics, CAD documentation, and clinical records.
• Audit documentation for compliance with applicable medical protocols, EMS regulations, billing requirements, company policies, and local, state, and federal law.
• Generate reports and communicate recurring documentation gaps, missing records, or compliance concerns to the appropriate supervisor or management team.
• Support documentation and review requirements for repetitive patients in accordance with company policy, when applicable.
• Protect confidential, proprietary, and patient information by following company security procedures, password requirements, HIPAA requirements, and all applicable privacy regulations.
• Maintain a clean, organized, secure, and shift-ready work area; ensure company records are appropriately filed and protected.
• Demonstrate professionalism and place customer service, compliance, patient care, and safety above all else.
• Perform other duties as assigned by management.