Clinical Support Specialist

Description

Department: Operations (CRT) | Reports to: Branch Manager & ATP Manager

Type: Full-time (On-site with limited local travel)

Pay: $24-26 per hour

Business Hours: Monday-Friday 8a-5p

Why this role matters

At Action Seating & Mobility, we help people with complex medical needs gain independence through Complex Rehab Technology (CRT). As a CSS, you’re the coordination hub for therapists, ATPs, payers, and clients—making sure documentation is right, authorizations get approved, and orders move. Your accuracy and follow-through directly impact how fast someone gets life-changing equipment.

What You’ll Do (core Outcomes)

• Authorization success & speed
• Prepare complete funding packets and submit within target timeframes (e.g., = 5 business days after final clinical docs).
• Track decisions; proactively close gaps to reduce rework/denials.
• Documentation quality
• Review LMNs, PT/OT evals, and physician notes for payer compliance; request corrections/clarifications quickly.
• Maintain low doc-error rates (goal set by branch leadership).
• Case flow & communication
• Own updates to clients, therapists, and ATPs; respond to messages within 1 business day.
• Keep EMR (Atlas) and trackers current so the team always knows status.
• Order readiness
• Generate accurate quotes; route clean orders to Purchasing with correct codes, documentation, and delivery notes.
• Escalate barriers early (clinic delays, missing signatures, payer nuances).
• Quality & compliance
• Follow HIPAA/PHI safeguards; be audit-ready at all times.
• Stay current on CO Medicaid and commercial documentation rules.
  

Requirements

Day-to-day responsibilities

• Partner with assigned ATP(s) to move cases from eval ? docs ? funding ? order submission.
• Validate clinical notes/LMNs against payer criteria (Medicare, Health First Colorado/Medicaid, and major commercial plans).
• Build and submit prior auths; maintain payer portals and decision logs.
• Create quotes; verify codes and coverage; flag non-covered items for ABN/waiver.
• Maintain clean, timely documentation in Atlas and standard branch trackers.
• Coordinate schedules with clinics/clients; support evaluation and delivery logistics (communication only).
• Provide courteous, proactive updates to clients, clinics, and internal teams.
• Contribute to branch huddles; suggest workflow improvements.
• Support onboarding of new CSS staff with tips/checklists once proficient.
  
  

What You Bring

• 1 year in CRT/DME, therapy clinic admin, payer authorization, or similar healthcare coordination.
• Working knowledge of payer documentation standards for CRT (Medicare, Medicaid, commercial).
• Strong organizer: can juggle 30–60 active cases while hitting deadlines.
• Clear, professional communicator; confident asking clinics for doc fixes.
• Systems: EMR/CRM (Atlas preferred), Microsoft 365/Google Workspace; comfortable with payer portals.
• Confidentiality mindset; HIPAA/PHI literate.
• Occasional local clinic visits; routine lifting limited to standard office needs.
  
  

Nice to have

• Prior CRT exposure (ATP workflows, LMN elements, wheelchair/seating terminology).
• Spreadsheet chops (filters, lookups, basic pivoting) for trackers and reports.
• Experience with CO Medicaid and regional MCO requirements.
  
  

What We Offer

• Competitive pay, medical/dental/vision, 401(k), life Insurance.
• Training on payer rules, documentation quality, and Atlas best practices.
  
  

A mission-driven team that values accuracy, urgency, and client dignity.