Medical Documentation Specialist
About The Position
Tactical Rehab is seeking detail-oriented, dependable, and service-minded individuals to join our growing team as a Medical Documentation Specialist. This position plays a critical role in getting our patients the equipment they need by managing prior authorizations, documentation accuracy, and reimbursement readiness from start to finish. As a Medical Documentation Specialist, you will review incoming authorizations, verify documentation and coding, coordinate with our offices on patient scheduling and delivery, and process fulfilled orders in the EMR. If you enjoy problem solving, take pride in accurate work, and want your attention to detail to directly improve patient care, we encourage you to apply.
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, or familiarity with military communities
Responsibilities
- Review incoming prior authorizations and verify that the requested product is an approved item Tactical Rehab offers.
- Process and follow up on prior authorizations through approval, denial, or resubmission.
- Confirm that patient records contain all information required for insurance reimbursement.
- Submit documentation corrections as allowed by predetermined policies.
- Initiate the office process 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 input accurate billing information for Team Leader review.
- Create patient files so offices can contact the patient and deliver the product.
- Review Proof of Delivery (POD) packets to confirm accuracy for reimbursement.
- Process fulfilled patient orders after validating and documenting any discrepancies in the EMR.
- Learn and apply OHI (Other Health Insurance) rules, including the effect on the patient and billing and the steps to verify 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, Dental, and Vision Insurance
- 401(k) Retirement Plan
- Paid Time Off (PTO)
- Paid Holidays
- Sick Leave
- Professional Development Opportunities
- Employee Recognition Program
- Certification Bonus Program
- One-Time Certification Bonuses
- Ongoing Certification Stipends
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
