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.
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
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