Documentation Specialist

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

📋 Description

• Review, analyze, and validate clinical documentation to ensure compliance with payers and readiness for billing.

• Collect and manage eligibility documents for patients, such as prescriptions, CMNs/LMNs, clinical notes, labs, and prior authorizations.

• Address pending revenue by reconciling documentation against outstanding charges.

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

• Identify trends in documentation and recurring problems, escalating issues and educating internal teams and provider offices as necessary.

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

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

• Communicate effectively 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 for physicians.

• Provide backup assistance for customer service inquiries.

• Meet established productivity, quality, and attendance standards.

• Perform additional duties as assigned.

⛳️ Requirements

• High School Diploma or equivalent work experience is mandatory.

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

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

• Excellent verbal and written communication skills.

• Outstanding customer service capabilities.

• Proficient in computer systems and software.

• Ability to thrive in a fast-paced environment and manage multiple tasks simultaneously.

• Background check is required for all positions.

• Motor Vehicle Record Check is necessary for all roles involving driving.

🏝️ Benefits

• Opportunities for support, development, and career advancement.

• Competitive salary and incentive programs.

• Comprehensive medical, dental, and vision coverage, effective the first of the month after hire.

• 401(k) plan with company matching contributions.

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

• Employee Stock Purchase Plan available.

• Paid Parental Bonding Leave.

• Short-term and Long-term Disability Insurance.

• Life and AD&D Insurance offered.

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

• CVS Minute Clinic and Teledoc services available.

• Spousal Advantage Reimbursement Plan included.

• Identity Theft Protection and Legal Plan provided.