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Shriners Children’s is a family that respects, supports, and values each other. We are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience defines us as leaders in pediatric specialty care for our children and their families.
Shriners Children's is the premier pediatric burn, orthopaedic, spinal cord injury, cleft lip and palate, and pediatric subspecialties medical center. We have an opportunity for a Patient Insurance Specialist & Documentation Auditor based at our Central Fabrication Center based in Tampa, FL.
The Patient Insurance Specialist & Documentation Auditor is an active member of the O&P Billing Team that delivers support consistent with the strategic vision, goals, philosophy and direction of Shriners Children's organization and POPS. The Specialist/Documentation Auditor is responsible for determining the status of a patient's insurance eligibility/coverage by contacting the appropriate insurance or third party Payor in accordance with POPS policies and procedures. The Specialist/Documentation Auditor must have a thorough knowledge and understanding of Commercial, Managed Care, Medicaid, Managed Medicaid and Medicare payor guidelines and eligibility criteria. The Specialist/Documentation Auditor will physically be located at the Central Fabrication Center in Tampa, FL but will perform insurance verification for assigned hospitals located throughout the U.S. The Specialist/Documentation Auditor is responsible for auditing Physician documentation and O&P documentation to ensure compliance with all State and Federal guideline, regulations, and payor requirements. The Specialist/Documentation Auditor is responsible for communication with Physicians and O&P practitioners to request additions and addendums to existing documentation when required, as well as having responsibility for communication with the Supervisor to discuss patterns, trends, or resistance to amending documentation when requested.Responsibilities:
Full Time
$33k-40k (estimate)
03/23/2024
04/16/2024