Clinical Documentation Specialist

Clinical Documentation Specialist

Innovive Health provides a supportive environment where clinicians can make a meaningful impact in the lives of patients by delivering care in the comfort of their home. Our dedicated teams go above and beyond to provide high-quality, compassionate care, and we believe the quality of our employees is the foundation of the care we deliver. Our employees are our biggest asset.

We offer a competitive salary and a generous benefits package. Flexible schedules to fit your lifestyle. Medical, dental, and vision benefit. Mileage reimbursement. 401k with company match. Dayforce Wallet - a voluntary benefit that gives you access to earned pay, Employee Assistance Program. Online CEU credits. Rewarding one-on-one care, one-on-one mentoring and 24/7 clinical support. Excellent career growth opportunities.

Department: Quality Improvement

Reports To: Sr. Manager, Clinical Documentation

FLSA Status: Non-Exempt

Position Summary

The Clinical Documentation Specialist is a vital link between our clinical care and our billing operations. Reporting to the Sr. Manager of Clinical Documentation, you will ensure the integrity of medical records and facilitate a seamless claims submission process. This role is perfect for a detail-oriented professional who enjoys problem-solving and collaborating with cross-functional teams to ensure compliance and accuracy.

Key Responsibilities

• Audit & Compliance: Review clinical documentation to ensure it meets rigorous billing requirements for specific insurance payers.
• Insurance Verification: Verify patient insurance coverage and proactively monitor/report eligibility changes to the appropriate departments.
• Claims Preparation: Generate and analyze reports to verify medical record completion prior to claims submission.
• Data Management: Update and maintain billing rules tailored to specific payers within our system.
• Internal Collaboration: Partner with clinical staff to secure missing or corrected documentation and provide support to the billing department on special projects.
• Problem Solving: Identify documentation gaps and resolve them in a timely manner to prevent billing delays.

Qualifications

• Education: Associate's degree required.
• Experience: Minimum of 1 year in a professional office setting.
• Technical Skills: Proficiency in Microsoft Office (specifically Word and Excel).
• Preferred: Background in Home Health Care billing. Familiarity with Medicare rules and regulations. Professional billing or coding certifications.

Physical Demands & Work Environment

• Stationary Tasks: Frequently required to sit for extended periods; continual use of hands/fingers for keyboarding and data entry.
• Mobility: Occasionally required to stand, walk, bend, or stoop.
• Lifting: Occasionally required to lift or move light materials (less than 25 lbs).

Innovive Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.