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AdaptHealth · 2 days ago

Documentation Specialist

Carthage, TN

Full-time

Onsite

Entry, Mid, Senior Level

1+ years exp

AdaptHealth is a provider of home medical equipment products and services. The Documentation Specialist is responsible for creating electronic forms for patient documents, managing eligibility documents, and ensuring compliance with healthcare regulations while maintaining a timely revenue cycle.

Health CareHospitalMedical Device

Responsibilities

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

Qualification

Health care administrative experienceInsurance billing knowledgeMicrosoft Office proficiencyCustomer service skillsAnalytical skillsTechnical aptitudePrioritizeDecision makingVerbal communicationWritten communicationAttention to detail

Required

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