Documentation Specialist

2 weeks ago

Columbia, United States AdaptHealth Full time
Job Duties:
  • Create and generate electronic forms requesting patient documents from physicians.
  • Collect and manage patient eligibility documents such as prescriptions, certificates of medical necessity, letters of medical necessity and prior authorizations.
  • Contact doctor offices as necessary to collect prescriptions, certificates of medical necessity, letters of medical necessity, clinical notes, and lab results.
  • Contact insurance companies to collect approved prior-authorization requests.
  • Escalate recurring problem accounts or physician groups or other trends to the management appropriately and in a timely manner.
  • Maintain regular, predictable, consistent attendance and flexibility to meet the needs of the department.
  • Understand and follow all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements.
  • Plan and organize work effectively and ensure its completion.
  • Meet all productivity requirements.
  • Demonstrate team behavior and promote a team-oriented environment.
  • Actively participate in continuous quality improvement.
  • Always represent the organization professionally.
  • Serve as backup to Customer Service department for customer concerns, issues, complaints, or questions.
  • Analyze documentation required for billing services and ensure compliance to payer requirements.
  • Resolve pending revenue by reconciling received documentation and pending charges.
  • Collaborates with physician offices, AdaptHealth sales and support staff to ensure timely receipt of documentation.
  • Identify trends and providing feedback and education to internal and external customers on compliant documentation requirements for services provided.
  • Requests authorization from state Medicaid programs.
  • Maintains and updates physician databases to ensure accurate delivery of billing documentation and communications with physician offices.


Competency, Skills and Abilities:

  • Decision Making
  • Analytical and problem-solving skills with attention to detail
  • Strong verbal and written communication
  • Excellent customer service skills
  • Proficient computer skills and knowledge of Microsoft Office
  • Ability to prioritize and manage multiple tasks
  • Reports To: Department Manager Approved by: Human Resources
  • Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction


Requirements

Minimum Job Qualifications:

  • High School Diploma or equivalent
  • One (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry
  • Senior level requires two (2) years of work-related experience and one (1) year of exact job experience
  • Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance.


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