Documentation Specialist

This is a fully remote position, open to applicants in Florida.

📋 Description

• Review, assess, and authenticate clinical documentation to ensure compliance with payers and readiness for billing.

• Gather and manage patient eligibility documents, prescriptions, CMNs/LMNs, clinical notes, lab results, and prior authorizations.

• Reconcile documentation with outstanding charges to address pending revenue issues.

• Request and monitor prior authorizations, coordinating with state Medicaid programs as needed.

• Identify trends in documentation and recurring issues; escalate concerns and educate internal teams and provider offices accordingly.

• Ensure adherence to Medicare, Medicaid, HIPAA, and private insurance regulations.

• Generate and oversee electronic documentation requests directed to physicians and insurance companies.

• Communicate with physician offices and payers to retrieve missing or incomplete documentation.

• Collaborate with sales, support, and customer service teams to facilitate timely billing processes.

• Maintain and update physician databases to ensure accurate communication and document delivery.

• Provide backup support for customer service inquiries as required.

• Meet established standards for productivity, quality, and attendance.

• Perform other duties as assigned.

⛳️ Requirements

• High School Diploma or equivalent work experience is required.

• At least one (1) year of administrative experience is necessary.

• Administrative experience in insurance, billing, claims, call center, or financial services is preferred.

• Strong problem-solving abilities with a keen attention to detail.

• Excellent verbal and written communication skills.

• Outstanding customer service skills.

• Proficient in computer and system operations.

• Ability to thrive in a fast-paced environment, including multitasking capabilities.

• Background check is required.

• Florida Care Provider Background Screening Clearinghouse screening, applicable for positions in Florida.

🏝️ Benefits

• Competitive Compensation and Incentives.

• Comprehensive Total Rewards & Benefits package.

• Extensive medical, dental, and vision coverage.

• 401(k) plan with company matching contributions.

• Paid Time Off Plans that include six paid holidays.

• Employee Stock Purchase Plan.

• Paid Parental Bonding Leave.

• Short and Long-term Disability Insurance.

• Life and Accidental Death & Dismemberment Insurance.

• Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA).

• Access to CVS Minute Clinic and Teledoc services.

• Spousal Advantage Reimbursement Plan.

• Identity Theft Protection and Legal Plan.

• Opportunities for Support, Development, and Advancement.