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Role Description
The Home Infusion Clinical Documentation Specialist is responsible for accurately and efficiently managing medical records and clinical documentation to ensure that authorization aligns with the prescribed therapy. This role requires a strong understanding of medical terminology to identify necessary criteria in compliance with healthcare regulations, coding standards, and patient care requirements.
• Recognizes patients’ rights and responsibilities and supports them in the performance of job duties; respects patient’s rights to privacy and confidentiality.
• Review and verify patient medical records for completeness, accuracy, and compliance with healthcare standards.
• Ensure proper documentation of diagnoses, treatments, and procedures to support coding and billing processes.
• Collaborate with physicians, nurses, and medical staff to clarify documentation and ensure consistency.
• Assist with the implementation of clinical documentation improvement (CDI) initiatives.
• Maintain electronic health records (EHR/ EMR) and ensure timely updates.
• Ensure compliance with HIPAA and other healthcare regulations regarding patient information security.
• Train and educate healthcare professionals on proper documentation practices.
• Identify and correct discrepancies or deficiencies in medical records.
• Follows up on pending or expired authorizations.
• Documents, in detail, phone calls, phone number, person spoken to and call details on a consistent basis.
• Maintains a thorough understanding of NDC (National Drug Code) numbers, billing units, metric quantities, etc.
• Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
• Shares knowledge gained with other staff members and works as a team member.
• Interact with others in a positive, respectful, and considerate manner.
• Performs other job-related duties as assigned.
Qualifications
• A high school diploma or GED is required; some college is preferred.
• A minimum of 2–3 years of relevant experience or an equivalent combination of education and experience is desired.
• Knowledge of insurance verification.
• Ability to communicate effectively and professionally with patients, visitors, physicians, and coworkers.
• Ability to make decisions, solve problems, and work independently with little supervision.
• Demonstrate extreme attention to detail and accuracy.
• Ability to prioritize and meet deadlines.
• Basic computer proficiency.
• Knowledge in the use of Microsoft applications.
Requirements
• Home Infusion experience preferred - IVIG products preferred.
Benefits
• Health, vision, and dental insurance
• Long term disability insurance
• Life insurance
• Vacation package
• 401K plan with a generous employer match
• Remote work from home opportunity
• Growth opportunities
Steps to Apply
To apply for this role, you must complete a Culture Index Assessment to be considered. Please note that your application will not be considered if the Assessment is not completed. Copy and paste the following link into your browser and press enter. Then, select the corresponding position for which you are applying. (Only one assessment per candidate is required.) The assessment is brief, taking less than ten minutes to complete.
portal.cultureindex.com/public/survey/general/0BFB8F0000