Documentation & Review Specialist

Unity Point at Home

Documentation and Review Specialist

Waterloo/ Des Moines / Sioux City / Quad Cities/ Cedar Rapids

Monday- Friday, 8a-5p

Full-Time, 40 Hours/ Week

Reviews all paperwork and patient accounts for accuracy in billing and rental equipment on an ongoing basis and

functions as a quality assurance resource to Home Medical Equipment Department. Reviews and manages all necessary

documentation needed for billing equipment/supplies to insurance.

• Responsible for looking at the individual needs of each patient/customer and matching those needs to the many services UnityPoint at Home has to offer; utilizing other members of the home care coordination team as necessary to coordinate services outside of the specialized service line.
• Processes all incoming work orders, interviewing client/referral source to secure demographic and financial and qualifying data, and securing verification and authorization of benefits as appropriate.
• Specializes in one or more of the agency’s service lines, yet is responsible for having a basic knowledge of all service lines.
• Directs inquiries and referrals to the appropriate individual and/or service line. Coordinates incoming calls from both referral sources and patient/customers.
• Initiates and coordinates prior authorization requests to third party payers and maintains a working knowledge of third party payer guidelines. Follows up with third party payers as necessary.
• Operates computer system to record/document and retrieve information to ensure appropriate agency services are provided in a timely manner.
• Establishes and maintains positive working relationships with current and potential customers and referral sources.
• Builds and monitors community and customer/referral source expectations and perceptions of UPAH as a high quality provider of services; maintaining excellent customer service.
• Assists other Intake/Home Care Coordinators as directed by the Intake/Home Care Coordination Manager.
• Maintains a working knowledge of relevant regulations affecting patients and the operation of our business.
• Performs patient follow up phone calls as directed by manager.
• Performs other duties specific to some service lines.
• Maintains regular and consistent attendance at work.
• Behaves in a manner consistent with company mission, vision and value statements.
• Maintains compliance with OSHA, accreditation standards and risk management guidelines.
• Maintains compliance with personnel policies and procedures.
• Behaves in a manner consistent with all corporate compliance policies and procedures.
• Performs other duties as requested by Intake/Home Care Coordination Manager to facilitate the smooth and effective operations of the organization.
• Meets measures as determined and required for job productivity and performance improvement.
• Employee is responsible for completion of communication tasks and activities in a timely manner. This would include, but is not limited to: responding to email, voicemail or telephone messages, promptly, accurately, and professionally; attending staff meetings as scheduled or viewing videotapes of those meetings; asking questions of team members and supervisors when needing clarification about various day-to-day issues or patient needs; and reviewing employee communication pieces, to stay aware of UnityPoint at Home programs and initiatives.
• Occasional after hours 

QUALIFICATIONS REQUIRED:

• Strong interpersonal skills.
• Strong problem solving skills with previous customer service experience.
• Basic knowledge of computer applications (i.e. Word, Excel) and operations.
• Ability to work as a collaborative team member.
• Ability to understand and apply guidelines, policies and procedures.

QUALIFICATION PREFERRED:

• Knowledge of medical terminology, anatomy and physiology.
• Knowledge of medical billing and collection practices.
• One year of medical experience; preferably in community home health or home medical equipment.