UnityPoint Health Documentation & Review Specialist in Urbandale, Iowa

Documentation and Review Specialist

Monday- Friday, Days, 8a-5p

Unity Point at Home

  • 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 or Infusion agency personnel.

  • 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.

  • Follows up with physicians on any delinquent documentation.

  • Reviews and tracks payer audits to provide necessary documentation for payment.

  • Serves as the liaison between order entry and billing.

  • Collaborates with management team to identify and prioritize quality improvement strategies that affect company operations.

  • 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.

  • 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.

  • Maintain regular and consistent attendance at work.

  • Behave in a manner consistent with Mission, Vision, Values and Expectations for Excellence.

  • Behave in a manner consistent with all corporate compliance policies and procedures.

  • Maintain compliance with OSHA, current accrediting agency and Risk Management guidelines.

  • Maintain compliance with personnel policies and procedures.

  • Perform special projects relating to specific service line when identified.

  • Be available for continual improvement of department and participate on a task force when appropriate.

  • Perform other duties as requested by the manager to facilitate smooth and effective operations of the organization.

  • 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 REQUIRED:

  • High school or vocational school graduate or an equivalent combination of education and 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

QUALIFICATIONS PREFFERRED:

  • Experience using Microsoft Office (Word, Excel)

  • Experience with quality assessment and monitoring activities.

  • Previous HME experience

  • Knowledge of medical terminology.

Requisition ID: 2018-44435

Street: 11333 Aurora Ave

Name: 9400 UnityPoint at Home Affiliate

Name: Admin- HME- DM

FTE (Numeric Only; Ex. 0.01): 1.0

FLSA Status: Non-Exempt

Scheduled Hours/Shift: Monday- Friday, 8a-5p

External Company Name: UnityPoint Health

External Company URL: http://www.unitypoint.org