Documentation Specialist

Job TitleBasic FunctionUnder the direction of the Inside Sales Supervisors, this position is responsible for all documentation activities relating to timely transitions of care.RequirementsHigh school diploma or equivalent.Minimum of one-year experience in DME or Medical Office Customer Service.Proven performance record in customer service.Strong knowledge of federal and state regulationsDemonstrates ability to work successfully with internal and external contactsStrong collaborative and skills in facilitating teamworkAbility to work independentlyDemonstrate excellent oral and written communication, problem solving, investigational and analytical skills along with excellent listening and interpersonal skillsAbility to multi-task, prioritize and manage time effectivelyADA Checklist For Physical Activities And Requirements, Visual Acuity, And Working Conditions Of The PositionPhysical Activity – Sedentary work, exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time at employee workstation. Occasionally move about the inside of the office to access office machinery, file cabinets, or attend meetings.Talking – Expressing or exchanging ideas by means of the spoken word.

Those activities in which they must convey detailed or important spoken instructions to other workers or customers accurately.Visual Acuity – The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures or viewing a computer terminal.Hearing – Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound.Conditions – The worker is not substantially exposed to adverse environmental conditions, tasks are completed in an office environment.Finger Dexterity – Typing or otherwise working, primarily with fingers rather than with the whole hand as in handling. Constantly operates a computer and other office productivity equipment, such as a desk telephone, cellphone, calculator, copy machine, and computer printer.Job Position DescriptionPrinciple Responsibilities:Gathers documentation needed to support medical necessity to submit Prior Authorization for Durable Medical Equipment.Submit and maintain prior authorizationsSubmit and maintain all certificate of medical necessity (CMN)Receives appropriate paperwork and prescriptions as requiredRequest documentation pertaining to continued need for PAP and Oxygen patientsReview and Complete Stop/Hold report for documentation related stops and holdsEnters all patient notes into EMR and verifies all information is complete and accurateKnowledge of Medicare LCD's and Qualifications for home medical equipmentMaintain current knowledge of Medicare, Illinois Public Aid and insurance industry policies and guidelinesInteracts in strict adherence to HIPPA compliance regulations and related company policiesUpload required documents to the patient accountResponds to customer requests courteously and with respectApproaches customers and inquiries in a manner which represents ownershipResolves customer complaints by investigating problems and making recommendations to executive leadershipRefers troubleshooting calls to appropriate departmentReports any patient or referral related problems to Lead immediatelyBuild and maintain positive relationships with referral sources to include education on medical equipment qualification and policy changesPromote company program and services to assigned referral source.Meets monthly and quarterly productivity goalsAdherence to the Prism's Employee HandbookAdherence to Prism's Policies and ProceduresSupports the mission, vision and strategic plan of the organization.Contributes to team effort by accomplishing related resultsCommunicate necessary information to the Managers and Co-workersParticipate in on-call schedule rotationAttend in-service training when requiredPerforms other duties as assigned