The Documentation Specialist assists in gathering necessary documentation for billing claims as well as working with insurance providers to obtain prior authorizations.

• Calling or faxing medical records along with prior authorization request to insurance companies.
• Reviews patient chart documentation for documentation necessary to process claims.
• Reviews reports frequently expiring authorizations or other documentation.
• Assists in maintaining EMR with current documentation.
• Assists in maintaining accurate information regarding payer documentation requirements.
• Perform other related duties as assigned.
• Responsible for obtaining and maintaining prior authorizations for care or services provided by the Division of Home Services
• Responsible for assisting home health agencies and dme stores with maintaining necessary documentation to bill claims.
• Responsible for assisting in maintenance of database of payer documentation requirements.

Education

• High school diploma required. 

Minimum Work Experience

• Minimum 1 year as a clerk in healthcare field

Required Skills, Knowledge, and Abilities

• Knowledge of Microsoft Excel, Word, and basic office machinery such as printer, copier, and fax machines required.

• Prior experience in EMR’s or medical documentation preferred.