Intake Clinical Reviewer

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Intake Clinical Reviewer

@ VieMed

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.  

  •  Performs a variety of systems administration and support tasks.
  •  Function as a clinical reviewer to inspect clinical records for the presence of documentation to support the validity of claims data submitted.
  •  Discern when missing medical record gaps exist and assist in directing request for additional records.
  •  Collaborates with peers and leadership
  •  Provides recommendations for action based on reviews of medical records with proper therapy. 
  •  Monitor’s healthcare documents to ensure compliance before submitting to insurance companies. Checking medical records for appropriate criteria. 
  •  Understand and comply with all governmental, regulatory and Viemed intake, billing and compliance regulations/policies including but not limited to Medicare and Medicaid programs
  •  Documents in computer system the status of referral
  •  Reports all concerns or issues directly to Intake Manager or Intake Supervisor
  • Other responsibilities and projects as assigned.

This position will require the employee to handle Protected Health Information (PHI) for duties related to document and report preparation.  Policies and procedures will be strictly adhered to make sure PHI is protected as required by the HIPAA Privacy Rule.


Qualifications:

Current Professional medical license. (RN, LPN, RT, etc.)

  • One (1) to two (2) years working for a Durable Medical Equipment company or relevant medical office experience preferred.
  • Basic understandings of medical insurance benefits
  • Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public.
  • Effectively communicate with physicians, patients, insurers, colleagues, and staff
  • Able to read and understand medical documentation effectively.
  • Knowledge and understanding of same and similar DME equipment.
  • Thorough understanding and maintaining of medical insurances company’s regulations and requirements to include but not limited to Medicare and Medicaid.
  • Learns and maintains knowledge of current patient database. 
  • Up to date with health information technologies and applications
  • Answers telephone in a polite and professional manner. Communicates information to appropriate personnel and management in a timely manner.
  • Establishes and maintains effective communication and good working relationships with co-workers, patients, organizations, and the public.  
  • Proficient in Microsoft Office, including Outlook, Word, and Excel
  • Utilizes initiative, strives to maintain steady level of productivity and is self-motivated.
  • Work week is Monday through Friday and candidates will work an agreed upon shift.
  • Possible weekend work or overtime, to include working an on-call rotation schedule.


How to Apply:

Please apply online at: https://viemedcompanies.apscareerportal.com/account

Visit Site to Apply

Location: Lafayette, LA
Date Posted: August 27, 2021
Application Deadline: September 28, 2021