Documentation Specialist

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

📋 Description

• Assess, examine, and verify clinical documentation to ensure compliance with payers and readiness for billing.

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

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

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

• Identify trends and recurring documentation issues; escalate concerns and provide training to internal teams and provider offices.

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

• Create and manage electronic documentation requests directed to physicians and insurance companies.

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

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

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

• Provide additional support for customer service inquiries as needed.

• Meet established productivity, quality, and attendance benchmarks while contributing to ongoing improvement efforts.

⛳️ Requirements

• High School Diploma or an equivalent level of work experience is required.

• Minimum of one (1) year of administrative experience in areas such as insurance, billing, claims, call center, or financial services.

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

• Excellent verbal and written communication skills.

• Outstanding customer service capabilities.

• Proficient in computer systems and software.

• Ability to thrive in a fast-paced environment, managing multiple tasks simultaneously.

• A company-conducted background check is mandatory for all positions.

🏝️ Benefits

• Opportunities for support, development, and career advancement.

• Competitive salary and incentive packages.

• Comprehensive rewards and benefits program.

• Extensive medical, dental, and vision insurance coverage.

• 401(k) plan with company matching contributions.

• Paid Time Off plans, including six paid holidays.

• Employee Stock Purchase Plan.

• Paid Parental Bonding Leave.

• Short-term 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.