Agency:
Alternate Solutions Health Network
Our culture and people are what set us apart from other post-acute care providers. We’re dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.
Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), require COVID-19 vaccinations for all Medicare and Medicaid certified providers. Based on this regulation, all of our employees must be fully vaccinated or have a valid exemption.
Schedule- 8-5 M-F in our Kettering, OH location.
HOW YOU'LL MAKE A DIFFERENCE:
At Alternate Solutions Health Network, we care for patients where they spend the majority of their time – in their homes. Today we care for patients who need skilled home care and hospice services. You won’t find our brand in many places because we partner with health systems, jointly running home health and hospice agencies that use their brand. This is part of our strategy. By being part of the health system team, we can ensure each patient has a well-coordinated care plan that remains consistent whether the patient is seeing their primary care physician, receiving treatment in a hospital, or under our care in the home.
As a Records Collection Specialist III, you are responsible for the collection, review and interpretation of documents required by health insurance payers to support the clinical necessity and documentation compliance for home health services.
WHAT WE OFFER:
We provide medical, dental, and vision insurance with flexibility for you to select what works best for you. Eligible teammates receive paid time off and may participate in the 401K, if they choose. Historically the company has matched 401K contributions which helps build your nest egg even faster. Finally, our benefit program includes company paid life, disability insurance, and a robust Employee Assistance Program.
HOW YOU'LL WORK:
You’ll review documentation based on organizational, commercial insurance and Medicare/Medicaid requirements, requesting and collecting missing or incomplete documents and obtaining appropriate signatures as required. These include Medicare Face-to-Face (F2F) Encounter documentation, referring physician orders, visit notes, hospital discharge information and certified home health plans of care. In addition, you will assist with the submission and troubleshooting of documentation as part of the Review Choice Demonstration (RCD) with Medicare Administrative Contractors.
MAJOR AREAS OF RESPONSIBILITY:
Operations: Effectively gather, review and troubleshoot required documentation with the use of electronic medical records (EMR) systems. Ensure alignment between patient diagnosis and referring provider Face-to-Face documentation.
Accuracy: Ensure Medicare Review Choice Demonstration requirements are sufficiently and timely met by existing documentation.
Communication: Communicate with referring providers and physicians to troubleshoot and resolve documentation questions, issues and gaps.
Problem Solving: Identify trends and issues in documentation quality and escalate to leadership as appropriate to resolve.
Collaboration: Collaborate with peers and other staff members to troubleshoot and resolve documentation questions, issues and gaps.
HARD & SOFT SKILLS:
Compassionate communicator with a positive attitude.
Dedication to process improvement and excellence.
Attention to detail is critical, as is being observant and following directions.
Excellent oral and written communication skills.
Proficiency in Microsoft Excel, Word, and Outlook. Experience working with computers is required.
Problem solving and create solutions to drive to a course of action.
REQUIREMENTS:
Licensed Practical Nurse (LPN) certification with a current license in the state of employment is preferred
Minimum clinical certification/licensure of a Medical Assistant, Emergency Medical Technician (EMT) or similar required
Minimum of 2 years’ experience in the health care industry; Home health intake experience highly preferred
Ability to maintain licensure as practicing Clinician per the state requirements, if applicable
Knowledge of Medicare Home Health documentation requirements including Face-to-Face (F2F) criteria is preferred
Experience reviewing Face-to-Face (F2F) documentation to validate homebound and skilled need components are met is preferred
Ability to leverage clinical training to interpret and identify primary diagnosis discrepancies in documentation is required
Knowledgeable on clinical best practices and HIPAA rules and regulations are required
Experience working with Electronic Medical Records (EMR) systems, such as Epic, Cerner, Homecare Homebase, Brightree or Kinnser/Wellsky is required
Experience working with WorldView, Forcura, eSolutions and e-fax systems is preferred
Capable of all physical demands
We’ll help you put your passion for patient care to work. Apply today!
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
We are an Equal Opportunity Employer.
