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Urgent! Medical Documentation Specialist Position in Observatorio - beBeeDocumentation

Medical Documentation Specialist



Job description

As a key member of our team, you will play a pivotal role in ensuring patient care is medically necessary and accurately documented.

In this dynamic environment, you will utilize your clinical expertise to review cases, guide physicians on documentation best practices, and navigate the complexities of insurance claims and denials.

Key Responsibilities:

  • Conduct thorough Utilization Reviews (UR) for patient admissions, services, and length of stay, assessing medical necessity against established criteria.

  • Perform concurrent chart reviews to ensure clinical documentation supports the level of care provided.

  • Act as a liaison between physicians and health plans, facilitating discussions on patient care and documentation requirements.

  • Analyze and appeal clinical denials from insurance payers by writing comprehensive medical necessity letters and compiling supporting evidence from medical records.

  • Identify gaps in clinical documentation and consult directly with attending physicians to ensure completeness and accuracy.

  • Meticulously document all actions and outcomes in the electronic medical record system.

  • Participate in peer review meetings and contribute to projects aimed at improving care quality and efficiency.

Benefits: Our organization offers a collaborative work environment, opportunities for professional growth and development, and a competitive compensation package.


Required Skill Profession

Other General



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