Billing QA, Lead

For over 29 years, Surgical Information Systems (SIS) has empowered surgical providers to Operate Smart™ by delivering innovative software and services that drive clinical, financial, and operational success. For ambulatory surgery centers (ASCs), SIS provides comprehensive software and services, including ASC management, electronic health records (EHRs), patient engagement capabilities, compliance technology, and revenue cycle management and transcription services, all built specifically for ASCs. For hospital perioperative teams, SIS offers an easy-to-use anesthesia information management system (AIMS).  
 

Serving over 2,700 surgical facilities, SIS is committed to delivering solutions that enable surgical providers to focus on what matters most: delivering exceptional patient care and outcomes.
 

Recognized as the No. 1 ASC EHR vendor by Black Book for 10 consecutive years and honored with the Best in KLAS Award for ASC Solutions in 2025, 2023, and 2022, SIS remains the trusted choice for surgical providers seeking to enhance their performance.
Discover how SIS can help you Operate Smart™ at sisfirst.com.

 

The Billing QA, Lead is responsible for leading quality reviews of billing activities to ensure accuracy, compliance, and adherence to established workflows and client-specific requirements. This role supports the Revenue Cycle Services team by identifying errors, documenting findings, and contributing to continuous improvement efforts that reduce rework, denials, and revenue leakage for Ambulatory Surgery Center (ASC) clients.

 

ESSENTIAL DUTIES/ RESPONSIBILITIES:

 

• Quality Audits & Reviews
  • Perform routine quality audits on billing activities, including charge entry, claim creation, claim submission, and corrections.
  • Validate accuracy of CPT/HCPCS codes, modifiers, diagnosis codes (as applicable), units, and claim formatting.
  • Ensure compliance with client-specific billing guidelines, payer rules, and internal SOPs.
  • Apply established QA scorecards and error definitions consistently.

• Documentation & Reporting
  • Document audit results clearly, including error categorization and supporting detail.
  • Enter audit findings into QA tracking tools and dashboards.
  • Escalate recurring or high-risk issues to the QA Manager per defined protocols.

• Continuous Improvement
  • Track error trends and contribute insights to help reduce downstream denials and rework.
  • Lead calibration sessions to ensure scoring consistency across QA reviewers.
  • Develop and refine updates to QA guidelines, audit checklists, and documentation as processes evolve.

  

• Collaboration & Feedback
  • Prepare and Present audit feedback with billing team leads and supervisors in a constructive, objective manner.
  • Partner with Training, Operations, and QA leadership to highlight common error trends.
  • Lead retraining efforts by identifying opportunities for process clarification or standardization.
  • Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time

 

SPECIFIC KNOWLEDGE & SKILLS REQUIRED:

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field or equivalent experience.
• 3-5 years of experience in healthcare revenue cycle billing.
• Experience in ASC billing is strongly preferred.
• Prior exposure to quality review, auditing, or compliance is a plus.
• Working knowledge of:
  • Medical billing workflows
  • CPT, HCPCS, ICD-10 (basic to intermediate level)
  • Payer claim submission requirements
• Experience with practice management and/or RCM systems.
• Strong attention to detail and accuracy.

BENEFITS:

• Benefit package including Medical, Vision, Dental, Short Term Disability, Long Term Disability, and Life Insurance
• Vacation/Sick time
• 401(k) retirement plan with company match
• Paid Holidays
• SIS Cares Day

We believe employees are our greatest asset and we empower them to make a difference in our business. Diversity and inclusion makes us all better. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, age, disability, protected veteran status, and all other protected statuses. 

Surgical Information Systems is an Equal Opportunity Employer and complies with applicable employment laws. M/F/D/V/SO are encouraged to apply.

At this time we are unable to sponsor H1B candidates

Qualifications Education Preferred High School or better. Bachelors or better. Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.