- Manage retrieval of medically necessary documentation including updated prescriptions, statements of medical necessity, medical records information, and other diagnostic reports from healthcare customers
- Maintain and sustain department service level agreements.
- Analyze documentation received to ensure medical requests are fulfilled.
- Resolve issues with any outstanding documentation requests defined as overdue. Solicit assistance from relevant stakeholders to initiate action plans necessary for retrieval.
- Review pertinent reports available to assist with management of administrative items and utilize for prioritization of workload.
- Educate healthcare accounts about documentation requests and the corresponding processes and regulations required by Medicare and other payers.
- Educate healthcare customers and employees on payer specific criteria.
- Assist with new employees and provide refresher training as needed.
- Participate in regional conference calls and regional meetings, as assigned.
- Communicate regularly with assigned field team regarding customer concerns or other escalated issues.
- Identify payer issues/trends and communicate payer updates to management as necessary.
- Ensure compliance with all payer rules and requirements.
- Develop and maintain relationships with internal and external stakeholders.
- Verify eligibility and benefits of plan coverage and process for payer, as necessary.
- Discuss Medicare or other relevant payer policies and limitations with Health Care Team
- High School diploma, required. Associate's degree or higher degree, preferred
- 3+ years industry experience (3rd party payers or DME provider experience), preferred.
- Medicare experience strongly preferred.
- Experience working in an office environment preferred.
- Knowledge of medical terminology, helpful
- Strong critical thinking and problem- solving skills.
- Outstanding written, verbal, and interpersonal communications
- Excellent attention to detail
- Ability to work independently and manage moderate to heavy workload.
- Proficient with Microsoft Office Software including Word and Outlook
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Medicare Documentation Specialist - St. Paul, United States - Hillrom
Description
This is where you save and sustain lives
At Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You'll feel a sense of purpose throughout the organization, as we know our work improves outcomes for millions of patients.
Baxter's products and therapies are found in almost every hospital worldwide, in clinics and in the home. For over 85 years, we have pioneered significant medical innovations that transform healthcare.
Together, we create a place where we are happy, successful and inspire each other. This is where you can do your best work.
Join us at the intersection of saving and sustaining lives- where your purpose accelerates our mission.
Your role at Baxter
THIS IS WHERE you build trust to achieve results...
The Medicare Documentation Specialist is responsible for requesting/managing supporting documentation and information required for claims submission and reimbursement for Medicare and other federal insurance. This role regularly interacts with patients, prescribers and their healthcare teams and will be required to build and maintain a professional relationship with these key customers. The Documentation Specialist plays a vital role in ensuring all payer rules and requirements are met and uphold Baxter's Respiratory Health high standard for Compliance.
What you'll be doing
What You'll Bring
#LI-DF1
Baxter is committed to supporting the needs for flexibility in the workplace. We do so through our flexible workplace policy which includes a minimum of 3 days a week onsite. This policy provides the benefits of connecting and collaborating in-person in support of our Mission.
We understand compensation is an important factor as you consider the next step in your career. At Baxter, we are committed to equitable pay for all employees, and we strive to be more transparent with our pay practices. The estimated base salary for this position is $41,600 to $57,200 annually. The estimated range is meant to reflect an anticipated salary range for the position. We may pay more or less than the anticipated range based upon market data and other factors, all of which are subject to change. Individual pay is based upon location, skills and expertise, experience, and other relevant factors. For questions about this, our pay philosophy, and available benefits, please speak to the recruiter if you decide to apply and are selected for an interview.
The successful candidate for this job may be required to verify that he or she has been vaccinated against COVID-19, subject to reasonable accommodations for individuals with medical conditions or religious beliefs that prevent vaccination, and in accordance with applicable law.
Equal Employment Opportunity
Baxter is an equal opportunity employer. Baxter evaluates qualified applicants without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity or expression, protected veteran status, disability/handicap status or any other legally protected characteristic.
EEO is the Law
EEO is the law - Poster Supplement
Pay Transparency Policy
Reasonable Accommodations
Baxter is committed to working with and providing reasonable accommodations to individuals with disabilities globally. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application or interview process, please click on the here and let us know the nature of your request along with your contact information.
Recruitment Fraud Notice
Baxter has discovered incidents of employment scams, where fraudulent parties pose as Baxter employees, recruiters, or other agents, and engage with online job seekers in an attempt to steal personal and/or financial information. To learn how you can protect yourself, review our .
Hillrom is an equal employment employer F/M/Disability/Vet/Sexual Orientation/Gender Identity. Please click To view the EEO is the Law poster.
Medicare Documentation Specialist professionals in Saint Paul
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Connor Swanson
ERP Professional
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Rebekah Thao
Waitress