Documentation Specialist

Documentation Specialist at AdaptHealth

At AdaptHealth, we offer full-service home medical equipment products and services to empower patients to live their best lives – out of the hospital and in their homes. We are actively recruiting for a Documentation Specialist who is passionate about making a profound impact on the quality of patients’ lives.

As a Documentation Specialist, you will be responsible for creating and generating electronic forms requesting patient documents from physicians and insurances, as well as collecting and managing patient eligibility documents. This role is crucial for maintaining a timely revenue cycle for all the goods and services provided by AdaptHealth.

Job Duties

• Create and generate electronic forms requesting patient documents from physicians.
• Collect and manage patient eligibility documents such as prescriptions, certificates of medical necessity, letters of medical necessity, and prior authorizations.
• Contact doctor offices as necessary to collect prescriptions, certificates of medical necessity, letters of medical necessity, clinical notes, and lab results.
• Contact insurance companies to collect approved prior-authorization requests.
• Escalate recurring problem accounts or physician groups or other trends to the management appropriately and in a timely manner.
• Maintain regular, predictable, consistent attendance and flexibility to meet the needs of the department.
• Understand and follow all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements.
• Plan and organize work effectively and ensure its completion.
• Meet all productivity requirements.
• Demonstrate team behavior and promote a team-oriented environment.
• Actively participate in continuous quality improvement.
• Always represent the organization professionally.
• Serve as backup to Customer Service department for customer concerns, issues, complaints, or questions.
• Analyze documentation required for billing services and ensure compliance with payer requirements.
• Resolve pending revenue by reconciling received documentation and pending charges.
• Collaborate with physician offices, AdaptHealth sales, and support staff to ensure timely receipt of documentation.
• Identify trends and provide feedback and education to internal and external customers on compliant documentation requirements for services provided.
• Request authorization from state Medicaid programs.
• Maintain and update physician databases to ensure accurate delivery of billing documentation and communications with physician offices.

Competency, Skills And Abilities

• Decision Making
• Analytical and problem-solving skills with attention to detail
• Strong verbal and written communication
• Excellent customer service skills
• Proficient computer skills and knowledge of Microsoft Office
• Ability to prioritize and manage multiple tasks
• Solid ability to learn new technologies and possess the technical aptitude required to understand the flow of data through systems as well as system interaction

Requirements

Minimum Job Qualifications:

• High School Diploma or equivalent
• One (1) year work-related experience in healthcare administrative, financial, or insurance customer services, claims, billing, call center, or management regardless of industry
• Senior level requires two (2) years of work-related experience and one (1) year of exact job experience
• Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance.

Key skills/competency

• Documentation Management
• Patient Eligibility
• Medical Necessity
• Prior Authorization
• Revenue Cycle
• HIPAA Compliance
• Communication Skills
• Problem Solving
• Microsoft Office
• Customer Service