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Records Collection Specialist III

  • Alternate Solutions Health Network
  • 03/29/20
  • Dayton, OH
  • 45420
  • negotiable / Yearly
  • Full-Time
Alternate Solutions Health Network is looking fora Records Collection Specialist IIIto join our team.

The Records Collection Specialist III is responsible for the collection, review and interpretation of documents required by health insurance payers to support the clinical necessity and documentation compliance for home health services. This role will be responsible for reviewing documentation based on organizational, commercial insurance and Medicare/Medicaid requirements, requesting and collecting missing or incomplete documents and obtaining appropriate signatures as required. These include Medicare Face-to-Face (F2F) Encounter documentation, referring physician orders, visit notes, hospital discharge information and certified home health plans of care. In addition, this role will assist with the submission and troubleshooting of documentation as part of the Review Choice Demonstration (RCD) with Medicare Administrative Contractors. This role will work significantly in electronic medical record (EMR) software to perform many of its job functions, in addition to the use of email, fax and phone. Where necessary, the role will collaborate with other departments and referring institutional and community providers to assist with the collection of documents in a timely manner. The responsibilities of this role when performed timely and accurately, have a direct effect on patient satisfaction, the organizations ability to provide care and the overall financial performance of the company. This role will comply with all legal, insurance/payer and company rules and regulations.

Our employees enjoy: Competitive Pay, Quarterly Bonuses, Medical/Dental/Vision Insurance, 401(k) Match, Verizon Wireless Discount, Paid Time Off, and more!

Effectively gather, review and troubleshoot required documentation with the use of electronic medical records (EMR) systems
Collaborate with peers and other staff members to troubleshoot and resolve documentation questions, issues and gaps
Communicate with referring providers and physicians to troubleshoot and resolve documentation questions, issues and gaps
Ensure Medicare Review Choice Demonstration requirements are sufficiently and timely met by existing documentation
Ensure alignment between patient diagnosis and referring provider Face-to-Face documentation
Compile and submit documents to Medicare Administrative Contractors as part of Review Choice Demonstration regulations
Identify trends and issues in documentation quality and escalate to leadership as appropriate to resolve
Perform duties accurately and efficiently with the use of a computer, fax, copier, scanner and phone
Other duties as assigned

Licensed Practical Nurse (LPN) certification with a current license in the state of Ohio and/or Florida is preferred
Minimum clinical certification/licensure of a Medical Assistant, Emergency Medical Technician (EMT) or similar required
Minimum of 2 years experience in the health care industry; Home health intake experience highly preferred
Ability to maintain licensure as practicing Clinician per the state requirements, if applicable
Knowledge of Medicare Home Health documentation requirements including Face-to-Face (F2F) criteria is preferred
Experience reviewing Face-to-Face (F2F) documentation to validate homebound and skilled need components are met is preferred
Ability to leverage clinical training to interpret and identify primary diagnosis discrepancies in documentation is required
Knowledgeable on clinical best practices and HIPAA rules and regulations are required
We can't wait to meet you!

Alternate Solutions Health Network is an Equal Opportunity Employer.

Follow the link below to apply:

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