Medical Documentation Spec
About The Position
Tactical Rehab is seeking a detail-oriented, dependable, and service-minded Medical Documentation Specialist to help patients receive needed equipment. The role manages prior authorizations, documentation accuracy, and reimbursement readiness from start to finish. The specialist reviews incoming authorizations, verifies documentation and coding, coordinates with offices regarding patient scheduling and delivery, and processes fulfilled orders in the EMR. The position supports billing and compliance requirements under Medicare, HIPAA, and other governmental regulations. It also involves learning and applying Other Health Insurance (OHI) rules and staying current on TRICARE and Humana Military billing changes through ongoing training. The role is based in Jacksonville, North Carolina.
Requirements
- High school diploma or GED.
- Excellent written and verbal communication skills.
- Strong organizational, research, and problem-resolution skills.
- Ability to multitask, prioritize, and work independently in a fast-paced environment.
- Comfort working with numbers and processing financial information.
- Ability to navigate multiple internet-based and billing applications.
Nice To Haves
- Certification in Medical Billing (CMRS or equivalent).
- Six months of experience in a healthcare setting, medical office, sports rehab, fitness, or retail environment.
- Experience with billing software or an EMR system.
- Military service, military spouse experience, or familiarity with military communities.
Responsibilities
- Review incoming prior authorizations and verify that requested products are approved items offered by Tactical Rehab.
- Process and follow up on prior authorizations through approval, denial, or resubmission.
- Confirm patient records contain all information required for insurance reimbursement.
- Submit documentation corrections as allowed by predetermined policies.
- Initiate office processes for patient/provider contact and appointment scheduling.
- Communicate with Office Managers to facilitate corrections that cannot be processed internally.
- Verify correct coding to support prompt payment and enter accurate billing information for Team Leader review.
- Create patient files so offices can contact patients and deliver products.
- Review Proof of Delivery (POD) packets for accuracy and reimbursement readiness.
- Process fulfilled patient orders after validating and documenting discrepancies in the EMR.
- Learn and apply OHI rules, including their effects on patients and billing and the steps for verifying OHI.
- Stay current on TRICARE and Humana Military billing changes through ongoing training.
- Support billing and compliance requirements in accordance with Medicare, HIPAA, and other governmental regulations.
- Ensure compliance with company policies, safety standards, and healthcare regulations.
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- 401(k) retirement plan
- Paid time off (PTO)
- Paid holidays
- Sick leave
- Professional development opportunities
- Employee recognition program
- Uniform stipend of $130
- One-time certification bonuses for listed certifications
- Ongoing per-pay-period stipends for listed active certifications
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
