Job Summary:

The Documentation Specialist for Durable Medical Equipment (DME) & Negative Pressure Wound Therapy (NPWT) provides coordination and oversight for the day-to-day operation, execution, and compliance of documentation between Wound Care Centers and partners. This includes but is not limited to medical records retrieval, verification, education, audit review of medical records and communication with clinical team with respect to documentation.

Essential Functions/Responsibilities:

• Routinely tracks and logs request on documentation and updates regularly to our

• Gather patient Medical Records/Documentation from i-Heal (Wound Assessments, Procedure

• Reviews Progress Notes (from Providers) from WCCs and Wound Assessments for checklist of Medicare LCD requirements and electronically sends them to Partner organization
• Communicates with WCC (CNM or Provider) when Progress Notes are not available or do not meet Medicare LCD requirements (i.e., duration of need, quantity per day, total quantity, etc.) in response to Partner request
• Requests Medical Records from other EMR systems outside of i-Heal, when applicable.
• Education calls to WCCs to educate and provide LCD resources for center documentation compliance.
• Reviews electronic orders real time and supports WCCs by sending Progress Notes and Wound assessment as part of documentation management process.
• Help with departmental audits and vendor audits by requesting, retrieving, and uploading

• Collaborates with Healogics Field Leadership around center specific education about Medicare LCD compliance with medical documentation.
• Assists in special projects around DME/NPWT
• Participate in improving quality throughout the organization
• Performs other duties as required

Required Education, Experience and Credentials:

• Associates degree from an accredited university or college in business, accounting, finance, healthcare administration or related field or equivalent experience
• Minimum of 5 years related experience in health care finance and/or revenue cycle in hospital, physician office or, other related setting. Minimum 2 years of experience in DME billing and collections.

Required Knowledge, Skills and Abilities:

• Working knowledge of DME coding, billing, payer requirements, denial management.
• Working knowledge of Negative Pressure Wound Therapy (NPWT)
• Must have a working knowledge of the CMS' codes, rules, regulations, pronouncements and applicable Fiscal Intermediary polices (e.g. Local Coverage Determinations).
• Familiarity with medical terminology.
• Proficient in Microsoft Suite (Excel, Word, Outlook)

• Keen attention to detail with the ability to work independently and maintain confidentiality
• Ability to collaborate and demonstrate leadership skills in a team environment
• Strong interpersonal, written and verbal communication skills with a focus on customer service
• Organization, prioritization and time management skills
• Working knowledge of systems/applications with indication of those preferred

• Demonstrated ability to exhibit integrity and commitment to professional ethics
• Budget and long-term planning skills