Clinical documentation specialist Jobs in Louisville, KY

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 to payer requirements.
• Resolve pending revenue by reconciling received documentation and pending charges.
• Collaborates with physician offices, AdaptHealth sales and support staff to ensure timely receipt of documentation.
• Identify trends and providing feedback and education to internal and external customers on compliant documentation requirements for services provided.
• Requests authorization from state Medicaid programs.
• Maintains and updates physician databases to ensure accurate delivery of billing documentation and communications with physician offices.

Competency, Skills and Abilities :

Requirements

Minimum Job Qualifications :