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UnityPoint Health Project Specialist Admin in West Des Moines, Iowa

Project Specialist Admin Assistant

Westlakes- Clive, IA

Monday- Friday, 8a-4:30p

Full-Time Benefits, 40 Hours/ Week

This position is primarily responsible for performing quality assurance review of billing documentation and coordination of

audit requests for UnityPoint at Home Health DME. The incumbent must possess a strong understanding of regulatory

standards and their impact on the provision of and reimbursement for home health products and services. This position

has a direct impact on revenue and reimbursement capture and requires a high level of efficiency and a high degree of

accuracy. The duties of this position include problem resolution and process improvement initiatives.

Quality Assurance

  • Performs the review and confirmation of work orders prior to billing, by verifying accuracy of order and required documentation such as prescriptions, certificates of medical necessity, prior authorizations, diagnosis and procedure codes.

  • Ensures the quality of billing information by verifying the completeness and accuracy of supporting documentation prior to submission of charges for reimbursement.

  • Accesses patient records in multiple software systems, research conflicting information and facilitate the procurement of appropriate documentation to update UPAH records to support reimbursement.

  • Monitors the confirmation work queue to ensure timely confirmation of work orders.

  • Tracks incomplete information and communicates feedback to management and intake staff.

  • Extends a high level of customer service to patients, providers, external and internal customers while resolving issues that impact regulatory documentation requirements & accounts receivable.

Quality Improvement

  • Retrieves, coordinates and tracks audit and documentation requests from payers to facilitate timely response and minimize the risk of negatively impacting billing privileges or appropriate reimbursement.

  • Maintains appropriate audit trails to document and justify actions taken.

  • Monitors document exceptions in OnBase, making corrections when necessary.

  • Identifies and reports potential OnBase document scanning issues to the HIM and IT Departments.

  • Organizes and prepares paper documents to be delivered to the HIM Department for scanning.

Departmental Support

  • Prepares initial, renewal and recertification CMNs for oxygen equipment and supplies.

  • Works with physician’s offices for timely and accurate completion of CMNs. 20%

  • Reviews completed CMN against supporting documentation to verify accuracy. * Follows up with physician’s office on any discrepancies or incomplete information.

Education:

  • High school or vocational school graduate or an equivalent combination of education and experience.

  • All staff are expected to participate in appropriate continuing education as may be requested and/or required by their immediate manager. In addition, staff are expected to accept personal responsibility for other educational activities to enhance job-related skills and abilities. All staff must attend mandatory educational programs.

Experience:

  • 3-5 years progressive experience in a business setting Current knowledge of Medicare and Medicaid standards and guidelines and regulations related to commercial insurance companies and private payers Proficiency with word processing and spreadsheet software

Requisition ID: 2021-94919

Street: 1776 West Lakes Pkwy

Name: 9400 UnityPoint at Home Affiliate

Name: Administrative Support

FTE (Numeric Only; Ex. 0.01): 1.0

FLSA Status: Non-Exempt

External Company Name: UnityPoint Health

External Company URL: http://www.unitypoint.org

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