UnityPoint at Home
Documentation & Review Specialist
Urbandale, IA
Monday-Friday 8:30AM-5:00PM
Full-time benefits
Reviews all paperwork and patient accounts for accuracy in billing and rental equipment on an ongoing basis and functions as a quality assurance resource to Home Medical Equipment Department. Reviews and manages all necessary documentation needed for billing equipment/supplies to insurance
Departmental Support
• Reviews all paperwork for accuracy, noting any missing or incomplete data and forwarding to appropriate person for completion when necessary.
• Confirms delivery tickets on a daily basis. Tickets must be entered into system on a timely, consistent manner to allow for prompt payments after money is booked to the system.
• Works the Billing Review queue on a daily basis.
• Reviews all documentation to identify any qualification issues.
• Works reports and held bills log to monitor accounts on hold due to documentation.
• Works queues to monitor CMN/SMN hold, authorization hold, qualify status, compliance status to keep revenue hold at a minimum.
• Works all incoming payer audits, recording information appropriately.
• Books charges for services/equipment rendered into the system accurately and completely.
• Assists with specific aspects of FDA guidelines and current accrediting agency to ensure paperwork meets expectations from these agencies.
• Functions as a quality assurance resource to HME
• Reviews patient accounts for accuracy in billing and rental equipment on an ongoing basis.
• Manages all necessary documentation needed for billing equipment/supplies to insurance. This may include, but is not limited to, SMN/CMN’s, sleep studies, nursing and physician records, authorizations, patient letters and physician letters.
• Manages PAP downloads for patient compliance when required.
• Manages necessary documentation for CHAP and/or FDA requirements such as annual oxygen prescription renewals.
• Reviews and tracks payer audits to provide necessary documentation for payment.
• Serves as the liaison between order entry and billing.
• Maintains current knowledge of carrier specific requirements by attending workshops, reading newsletters, and acting as a liaison in carrier meetings and sharing information with other HME personnel.
• Specified employees will manage consignment paperwork. This will include patient entry, order and ticket entry, ticket confirmation and review. Some CMN/SMN management will be included in the consignment process.
• Meets measures as determined and required for job productivity and performance improvement.
Customer Services
• Communicates identified problems to appropriate staff to assure follow up is completed to expedite claims and ensure timely and accurate payment.
• Works with HME staff to educate on any documentation updates or concerns
• Collaborates with management team to identify and prioritize quality improvement strategies that affect company operations.
• Follows up with physicians on any delinquent documentation.
• Employee is responsible for completion of communication tasks and activities in a timely manner. This would include, but is not limited to: responding to email, voicemail or telephone messages, promptly, accurately, and professionally; attending staff meetings as scheduled or viewing videotapes of those meetings; asking questions of team members and supervisors when needing clarification about various day-to-day issues or patient needs; and reviewing employee communication pieces to stay aware of UnityPoint at Home programs and initiatives
Education:
Experience:
Why UnityPoint Health?
Visit https://dayinthelife.unitypoint.org/ to hear more from our team members about why UnityPoint Health is a great place to work.
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