Medicare Documentation Specialist
| Company | Owens & Minor |
|---|---|
| Location | Downers Grove, IL, USA |
| Salary | $20 – $20 |
| Type | Full-Time |
| Degrees | |
| Experience Level | Entry Level/New Grad, Junior |
Requirements
- Excellent communication skills and the ability to practice proper phone and email etiquette
- Skilled in answering a telephone in a pleasant and helpful manner
- Ability to read, understand and follow oral and written instructions
- Proficient with medical terminology and insurances HCPC/ICD-9 codes
- Documents activities in ERP system in an efficient accurate and timely manner
- Proficient in Microsoft Office, particularly Word, Excel and Outlook
- Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
- Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule format
Responsibilities
- Request medical documentation and assure received documentation meets insurance payer guidelines
- Responsible for accurate and timely response to any audits received
- Log and report all received audit inquiries including prepayment audits, post payment requests, overpayment refund requests, medical necessity documentation requests, billing/coding audits, and full scale random sampling audits
- Gather and collate all existing documentation required including Proof of Delivery, billing forms, signature attestations, signature authorizations, letters of medical necessity, patient logs, etc.
- Review all documentation to be submitted for audit purposes for completeness and accuracy
- Report to supervisor any apparent issues and coordinate submission of all required documentation
- Work with billing and collection teams to assure timely submission of all appeals
- Track and report audit findings and results
- Evaluate and secure the needed Rx’s, PA’s and medical justification to facilitate payment of claims for initial and review/appeals payments
- Edit and resubmit claims for payment
- Prepare and review clean claims for submission to various insurances either electronically or by paper
- Provide feedback to Group Team Lead regarding issues regarding accounts
- Conduct routine tasks as directed; work under clearly defined guidelines
- Contribute to specific objectives and outcomes as directed
Preferred Qualifications
-
No preferred qualifications provided.