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The Documentation Specialist manages medical documentation to secure insurance prior authorizations and reimbursements for clients. They act as a liaison between medical providers, therapists, and clients to resolve funding requests and ensure audit-ready compliance.
Statement of the Position:
The Documentation Specialist secures, reviews, and validates medical documentation required to secure insurance payer prior authorization and reimbursement for NSM clients. Operating with minimal supervision, the Documentation Specialist maintains consistent communication with physicians, therapists, and clients to resolve outstanding funding requests and ensure audit-ready compliance.
Company Description:
At all levels, working at National Seating & Mobility provides the opportunity to directly impact our client’s lives by giving them self-reliance and independence. Our teams are comprised of passionate individuals, dedicated to providing the best care to each client. We focus on abilities by leveraging technology and creating mobility solutions that are as unique as our client’s needs.
Duties and Responsibilities / Essential Functions:
1. Coordinates directly with medical providers to gather all necessary documentation—including progress notes, prescriptions, face-to-face examinations, letters of medical necessity, and Assistive Technology Professional (ATP) evaluations—strictly adhering to specific payer guidelines and timelines.
2. Serves as a primary liaison by maintaining regular, professional contact with non-restricted referral sources, physicians, physical/occupational therapists, ATPs, and clients to pursue missing or incomplete records.
3. Conducts rigorous reviews of incoming medical files to verify policy compliance, accurately identifies and titles each document type, and validates information before final preservation in the electronic medical record.
4. Prioritizes and drives the timely resolution of all "Funding Action Required" items to prevent delays.
Work Environment:
This role operates in a professional corporate office or an approved, secure, and HIPAA-compliant home office. The position routinely requires the use of standard digital office equipment and productivity tools.
Physical Demands:
Required Education, Experience & Competencies:
#NSMT1
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