Clinical Documentation Specialist

Innovive Health • Medford, MA

1d • Onsite

About The Position

The Clinical Documentation Specialist is a vital link between our clinical care and our billing operations. Reporting to the Sr. Manager of Clinical Documentation, you will ensure the integrity of medical records and facilitate a seamless claims submission process. This role is perfect for a detail-oriented professional who enjoys problem-solving and collaborating with cross-functional teams to ensure compliance and accuracy.

Requirements

• Associate’s degree required.
• Minimum of 1 year in a professional office setting.
• Proficiency in Microsoft Office (specifically Word and Excel).

Nice To Haves

• Background in Home Health Care billing.
• Familiarity with Medicare rules and regulations.
• Professional billing or coding certifications.

Responsibilities

• Review clinical documentation to ensure it meets rigorous billing requirements for specific insurance payers.
• Verify patient insurance coverage and proactively monitor/report eligibility changes to the appropriate departments.
• Generate and analyze reports to verify medical record completion prior to claims submission.
• Update and maintain billing rules tailored to specific payers within our system.
• Partner with clinical staff to secure missing or corrected documentation and provide support to the billing department on special projects.
• Identify documentation gaps and resolve them in a timely manner to prevent billing delays.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree