Referral & Document Management Specialist II

Why Us?

With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. With 160 years of clinical excellence and innovation, Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

Could This Be For You?

The Referral & Document Management Specialist II - Remote reviews and coordinates the intake and processing of patient care related documents. Collaborates with internal and external partners to ensure appropriate clinical documentation is received to prevent delays in patient care. Provides support to the local clinics and consolidated teams to ensure documentation meets the compliance requirements. Assembles documents to complete PAR packets.

 

This role will be supporting the Great Lakes region. All candidates are eligible to apply. Preferred candidates will have knowledge of Great Lakes payer knowledge and office administrative experience.

Your Impact

Document Management

• Ensures all incoming patient care documentation is reviewed and appropriately filed into patient chart.
• Timely communication to clinics and or referral sources
• Send out attestations to physician when required.
• Worklog review and document requests
• Work Document Management and Auth tasks as needed.
• Taks appropriate verification teams
• Follow-up on requested documents
• Communicate with office when further information is required.
• Communicate with office and update when admin is complete.
• Communicates with external partners to ensure documentation requests are received.
• Educates external partners on documentation standards and facilitates updates to documentation when needed.
• When necessary and once documentation is complete and accurate PAR packet is assembled and tasked to authorization team for submission

 

Document Review/Audit:

• Reviews documentation to ensure it meets needs of payer and medical policy.
• Verifies diagnosis code on patient billing is accurate and reimbursable.
• Communicates with clinician when coding issues occur.

Minimum Qualifications

• A high school diploma or equivalent
• Minimum of 2 years insurance verification and/or benefits experience.

• Must have, or be eligible to obtain, a valid driver’s license and driving record within the standards outlined within Hanger’s Motor Vehicle Safety Policy and Procedures. 

Additional Success Factors

• Able to initiate communication with clinic staff and insurance companies.
• Excellent customer service and communication skills
• Able to manage multiple responsibilities and to prioritize duties/tasks in a fast-paced working environment.
• Good interpersonal, oral and written communication skills, including the ability to follow written and verbal directions.
• Resourceful and flexible team player who excels at building trusting relationships with patients, referral sources and colleagues.
• Working knowledge of HIPAA and other medical insurance regulations and terminology for private payer, state and federal plans including coding, billing, and reimbursement protocols
• Working knowledge of ICD-9, ICD-10, HCPC/CPT and other coding
• Proficient computer software, such as MS Word, Excel, and automated billing systems
• Able to use various types of office equipment, such as, facsimile machines, calculator, postage machine, copiers, etc
• Knowledge of state, federal and regional collection, and reimbursement laws
• Must have an enthusiastic and positive attitude.
• Ability to work independently, exercise creativity, and be attentive to detail.
• Ability to work independently, exercise creativity, and be attentive to detail.
• Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships.
• Keep the patient at the center of everything that you do, building lifelong trust.
• Foster open collaboration and constructive dialogue with everyone around you.
• Continuously innov