sms-documentation specialist

22 hours ago

Lansing, Michigan, United States University of Michigan Health-Sparrow Full time

Job Opportunity
Job ID: 50876
Full-Time M-F
Description:
Positions Location:
Lansing, MI

Job Description
General Purpose of Job
:

Responsible for supporting Sparrow Medical Supply goals and objectives by ensuring that all Certificates of Medical Necessity (CMN's) and physician orders are processed timely and accurately and meet insurance requirements in accordance with established standards.

Essential Duties
This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

  • Processes renewal CMN's 60 days prior to expiration.
  • Updates TIMS CMN file with updated information when completed form is returned.
  • Answers physician's questions related to insurance documentation, as appropriate.
  • Daily prints and sorts the TIMS spool file for all CMNS created in the daily batch.
  • Daily reviews all CMN's for accuracy prior to their delivery to area physicians' offices.
  • Organize CMNS for daily mailing or delivery to physician offices.
  • Once CMN's/orders are completed and returned by appropriate physicians, reviews for completion and qualification of insurance benefits.
  • Enters information from returned CMN into TIMS CMN file (e.g., diagnosis, start date of DME, return date of DME).
  • After information has been entered into TIMS, forwards paperwork to Data Processing-Imaging Clerk.
  • Works with A/R Specialists and other SMS Caregivers to obtain and ensure accurate insurance information for patients.
  • Utilizes Diver to identify non returned CMNS for resubmission every 60 days.
  • Open and sort incoming CMNS from US mail, internal mail, physician offices.
  • Assists in tracking and providing follow up to physicians for all outstanding CMN's.
  • Communicates with patients/customers when necessary to obtain missing/incomplete information for proper documentation.
  • Adheres to Corporate Compliance Policies, including but not limited to current Medicare regulations.

Job Requirements
General Requirements None

Work Experience Minimum one year experience in Customer Service in medical supply or other health care environment.

Education High School diploma or GED.

Specialized Knowledge and Skills Familiarity with ICD-10 coding, HCPCS and medical terminology. Demonstrated knowledge of database software programs; data processing experience. Good math and organizational skills necessary. Excellent communication skills, both verbal and written. Demonstrated people-sensitive characteristics with a genuine desire to help others

Sparrow Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

Requirements
Job Family
Service/Support/Skilled Maintenance
Requirements:
Shift Days

Degree Type / Education Level High School / GED

Status Full-time

Facility Sparrow Medical Supply

Experience Level New Grad

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