Trident Pain Center ยท 15 hours ago
Medical Necessity Specialist
North Charleston, SC, South Carolina
Full-time
Onsite
New Grad, Entry LevelTrident Pain Center is a busy pain management clinic seeking a highly detail-oriented and motivated Medical Necessity Specialist. This entry-level role involves reviewing provider documentation to ensure accuracy, completeness, and compliance with medical necessity guidelines, directly supporting billing and insurance claims processing.
Health CareOutpatient CarePsychologyTherapeutics
Responsibilities
Review provider documentation (including visit notes, procedure reports, and diagnostic summaries) for accuracy, completeness, and medical necessity
Identify missing or unclear information and coordinate with providers or clinical staff for clarification or correction
Ensure documentation meets payer guidelines and regulatory standards for medical necessity and coding support
Maintain up-to-date knowledge of payer requirements and documentation standards related to pain management services
Assist in preparing documentation for audits, prior authorizations, or appeals, as needed
Track and report documentation trends or recurring issues to supervisor or quality assurance team
Maintain patient confidentiality and comply with all HIPAA regulations and clinic policies
Qualification
Required
Highly detail-oriented and motivated
Ability to review provider documentation for accuracy, completeness, and compliance
Knowledge of medical necessity guidelines
Ability to coordinate with providers or clinical staff for clarification or correction
Understanding of payer guidelines and regulatory standards for medical necessity and coding support
Ability to maintain up-to-date knowledge of payer requirements and documentation standards related to pain management services
Ability to assist in preparing documentation for audits, prior authorizations, or appeals
Ability to track and report documentation trends or recurring issues
Ability to maintain patient confidentiality and comply with all HIPAA regulations and clinic policies
Company
Trident Pain Center
Trident Pain Center offers treatment for acute and chronic pain.
Founded in 2002North Charleston, South Carolina, USA
11-50 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase