Medicare Documentation Specialist-2 at O & M Halyard, Inc. in White Plains, New York

Job Description:

At Owens & Minor, we are a critical part of the healthcare process. As a Fortune 500 company with 50+ facilities across the US and 18,000 teammates in over 90 countries, we provide integrated technologies, products and services across the full continuum of care. Customers—and their patients—are at the heart of what we do.

Our mission is to empower our customers to advance healthcare, and our success starts with our teammates. 

Owens & Minor teammate benefits include:

• Medical, dental, and vision insurance, available on first working day


• 401(k), eligibility after 30 days of employment


• Employee stock purchase plan


• Tuition reimbursement


• Development opportunities to grow your career with a global company

POSITION SUMMARY: 

This representative will be required to request Medical documentation and assure received documentation meets insurance payer guidelines. When applicable, the audit coordinator will be responsible for accurate and timely response to any audits received.

ESSENTIAL TASKS: 

Must possess excellent communication skills and the ability to practice proper phone and email etiquette,

• Skilled in answering a telephone in a pleasant and helpful manner.


• Ability to read, understand and follow oral and written instructions.


• Proficient with medical terminology and insurances HCPC/ICD-9 codes,

• Documents activities in ERP system in an efficient accurate and timely manner.


• Log and report all received audit inquiries including:
  
  
  • Prepayment audits/development letters
  
  
  • Post payment requests for documentation
  
  
  • Overpayment refund requests
  
  
  • Medical necessity documentation requests and cert audits
  
  
  • Billing/coding audits
  
  
  • Full scale random sampling audits
  
  
  
  


• Gather and collate all existing documentation required including Proof of Delivery, billing forms, signature attestations, signature authorizations and assignment of benefits, letters of medical necessity, patient logs, etc.


• Review all documentation to be submitted for audit purposes for completeness and accuracy.


• Report to supervisor any apparent issues and coordinate submission of all required documentation.


• Work with billing and collection teams to assure timely submission of all appeals.


• Track and report audit findings and results

• Ability to evaluate and secure the needed Rx’s, PA’s and medical justification to facilitate payment of claims for initial and review/appeals payments.


• Ability to edit and resubmit claims for payment.


• Prepares and reviews clean claims for submission to various insurances either electronically or by paper.


• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.  Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule format.


• Proficient in Microsoft Office, particularly Word, Excel and Outlook.


• Provide feedback to Group Team Lead regarding issues regarding accounts.


• Conducts routine tasks as directed; works under clearly defined guidelines.


• Contributes to specific objectives and outcomes as directed.

If you feel this opportunity could be the next step in your career, we encourage you to apply.

Owens & Minor is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, sex, sexual orientation, genetic information, religion, disability, age, status as a veteran, or any other status prohibited by applicable national, federal, state or local law.

Salary: