Homecare WCC Specialist

SOLVENTUM•San Antonio, TX

1d•$45,360 - $62,370•Hybrid

About The Position

Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers’ toughest challenges. As a WCC Specialist, you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. You will make an impact by collecting and analyzing all documentation needed for billing. You will act as the liaison between customer, Solventum, and third-party payer to ensure the order meets regulatory and payer requirements. You will develop a robust relationship cadence with Wound Care professionals and field personnel which results in greater ease of doing business with Solventum.

Requirements

High School Diploma/GED from an accredited institution.
Two (2) years of experience reviewing, analyzing, and interpreting medical records in a private, public, government, or military environment.
Demonstrated customer service experience in a healthcare, insurance, patient support, or related environment.
Intermediate proficiency with Microsoft Office applications, including Word, Excel, Outlook, and email communication.
Demonstrated ability to work effectively both independently and within a collaborative team environment.
Ability to manage multiple priorities, adapt to changing business needs, and perform successfully in a fast-paced environment.
Ability to perform extensive computer-based work, including repetitive keyboarding and frequent telephone communication.
Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).

Nice To Haves

Associate's Degree or Bachelor's Degree in Healthcare Administration, Health Information Management, Business Administration, or a related field from an accredited institution.
Experience working in a post-acute care setting, including Home Health Agencies, Skilled Nursing Facilities, Wound Care Centers, or with providers serving these markets.
Experience reviewing, analyzing, and interpreting medical records to support reimbursement, billing, or clinical documentation processes.
Experience working with healthcare payers, insurance authorizations, claims processing, or revenue cycle management activities.
Strong communication, organization, problem-solving, and customer relationship management skills.

Responsibilities

Collecting and analyzing all documentation needed for billing.
Acting as the liaison between customer, Solventum, and third-party payer to ensure the order meets regulatory and payer requirements.
Developing a robust relationship cadence with Wound Care professionals and field personnel which results in greater ease of doing business with Solventum.
Demonstrating complete knowledge of the Solventum document collection process which includes understanding of 4 major departments within the Advantage Center: Order Management (some Initial Cycle Documentation), WDT (Wound Documentation), PDT (Prescriber Documentation), POD (Proof of Delivery).
Utilizing independent problem-solving skills to develop streamlined processes to limit contact with Wound Care Clinics while staying within the confines of Solventum process and procedure rules.
Reviewing and analyzing payer specific requirements and coverage criteria to determine required documentation and accurate billing criteria.
Conducting in-depth review of clinical documentation (medical records, prescriptions, operative reports, history and physicals) based on billing criteria.
Working with Wound Care Clinics or field personnel to obtain missing documentation required for placement and/or billing.
Providing a high level of customer service in a competitive market.
Participating in any and all reasonable work activities as may be deemed suitable and assigned by management.
Conforming to, supporting and enforcing all Company policies and procedures.
Providing backup assistance to team members when needed.
Complying with corporate policies, procedures and security standards while performing assigned duties.