Documentation Specialist

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

📋 Description

• Evaluate, analyze, and confirm clinical documentation to ensure payer compliance and readiness for billing.

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

• Address outstanding revenue by reconciling documentation with pending charges.

• Initiate and monitor prior authorizations, coordinating with state Medicaid programs as necessary.

• Recognize documentation patterns and recurring challenges, escalating issues or providing education to internal teams and provider offices.

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

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

• Interact with physician offices and payers to secure missing or incomplete documentation.

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

• Maintain and update databases of physicians.

• Act as backup support for customer service inquiries.

• Achieve productivity, quality, and attendance benchmarks.

• Carry out any additional duties as assigned.

⛳️ Requirements

• A High School Diploma or equivalent work experience is required.

• At least one (1) year of administrative experience, encompassing insurance, billing, claims, call center, or financial services.

• Strong problem-solving abilities with meticulous attention to detail.

• Excellent verbal and written communication skills.

• Superior customer service capabilities.

• Proficient in computer and system operations.

• Capacity to thrive in a fast-paced environment while managing multiple tasks.

• A company-conducted Background Check is mandatory for all positions.

🏝️ Benefits

• Competitive Compensation and Incentives.

• Comprehensive Total Rewards & Benefits.

• Extensive medical, dental, and vision coverage (eligible the first of the month following hire).

• 401(k) plan with company match.

• Paid Time Off Plans, which include 6 paid holidays.

• Employee Stock Purchase Plan.

• Paid Parental Bonding Leave.

• Short and Long-term Disability Insurance.

• Life and AD&D 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.