Clinical Documentation Specialist

Overview

UnityPoint at Home

Documentation & Review Specialist

Urbandale, IA

Monday-Friday 8:30AM-5:00PM

Full-time + benefits

• This person is able to sit in Des Moines, Sioux City, Fort Dodge, Cedar Rapids, Waterloo, Quad Cities or Peoria

Responsibilities

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

Qualifications

Education:

• High school diploma/GED

Experience:

• Strong interpersonal skills

• Strong verbal and written communication skills

• Ability to work as a collaborative team member.

• Ability to understand and apply guidelines, policies and procedures

Why UnityPoint Health?

• Commitment to our Team

• For the second consecutive year, we're proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare for our commitment to our team members.

• Culture

• At UnityPoint Health, you Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve.

• Benefits

• Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you're in.

• Diversity, Equity and Inclusion Commitment

• We're committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.

• Development

• We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.

• Community Involvement

• Be an essential part of our core purpose-to improve the health of the people and communities we serve.

Visit https://dayinthelife.unitypoint.org/ to hear more from our team members about why UnityPoint Health is a great place to work.

#UPaHomeNursing

• Area of Interest: Patient Care;

• FTE/Hours per pay period: 1;

• Department: Centralized HME Ops;

• Shift: FT 1.0 - M-F 7-5 hours some flexibility;

• Job ID: 145536;