Documentation Specialist - Chelmsford, MA

Chelmsford, MA, USA Req #763

AdaptHealth is a premier full-service home medical equipment company in the United States offering a full-scope of cost-efficient HME and respiratory care products and services that aim to keep patients comfortable and thriving in their own homes.

We are dedicated to pursuing better and use technology, process and the power of our national network to do so. We have a relentless commitment to using innovation to transform the durable medical equipment industry, break the status quo and provide the best quality care.

Position Summary :

Documentation Specialists create and generate electronic forms requesting patient documents from physicians and insurances, as well as collecting and managing patient eligibility documents.

Additionally, responsible for maintaining a timely revenue cycle for all the goods and services provided by AdaptHealth.

Essential Functions and Job Responsibilities :

• Creates and generates electronic forms requesting patient documents from physicians.
• Collects and manages patient eligibility documents such as prescriptions, certificates of medical necessity, letters of medical necessity and prior authorizations.
• Contacts doctors’ offices as necessary to collect prescriptions, certificates of medical necessity, letters of medical necessity, clinical notes, and lab results.
• Contacts insurance companies to collect approved prior-authorization requests. Escalates recurring problem accounts or physician groups or other trends to the management appropriately and in a timely manner.
• Maintains regular, predictable, consistent attendance and flexibility to meet the needs of the department.
• Understands and follows all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements.
• Plans and organizes work effectively and ensures its completion.
• Meets all productivity requirements.
• Demonstrates team behavior and promotes a team-oriented environment.
• Actively participates in continuous quality improvement.
• Always represents the organization professionally.
• Serves as backup to Customer Service department for customer concerns, issues, complaints, or questions.
• Analyzes documentation required for billing services and ensures compliance to payer requirements.
• Resolves pending revenue by reconciling received documentation and pending charges.
• Collaborates with physician offices, AdaptHealth sales and support staff to ensure timely receipt of documentation.
• Identifies trends and provides 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.
• Maintains patient confidentiality and functions within the guidelines of HIPAA.
• Completes assigned compliance training and other educational programs as required.
• Maintains compliance with AdaptHealth’s Compliance Program.
• Performs other related duties as assigned.

Competency, Skills and Abilities :

• Analytical and problem-solving skills with attention to detail.
• Strong verbal and written communication.
• 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 flow of data through systems as well as system interaction.

Education and Experience Requirements :

• High School Diploma or equivalent.
• One (1) year work-related experience in health care 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.

Physical Demands and Work Environment :

• Work environment may be stressful at times, as overall office activities and work levels fluctuate.
• Must be able to bend, stoop, stretch, stand, and sit for extended periods of time.
• Subject to long periods of sitting and exposure to computer screen.
• Ability to perform repetitive motions of wrists, hands, and / or fingers due to extensive computer use.
• Must be able to lift 30 pounds as needed.
• Excellent ability to communicate both verbally and in writing.
• May be exposed to angry or irate customers or patients.

Benefits : Medical, Vision, Paid Time Off, 401k.

AdaptHealth is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the basis of an individual’s race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law.

This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.

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