Medical Documentation Specialist
About the role
Tactical Rehab is seeking a Medical Documentation Specialist to join their team in Quantico, VA. This role is crucial for ensuring patients receive the necessary equipment by managing prior authorizations, documentation accuracy, and reimbursement.
Responsibilities
- Review incoming prior authorizations and verify that the requested product is an approved item at Tactical Rehab.
- Process and follow up on prior authorizations through approval, denial, or resubmission.
- Confirm that patient records contain all information required for insurance reimbursement.
- Submit documentation corrections as allowed by predetermined policies.
- Initiate the office process for patient/provider contact and appointment scheduling.
- Communicate with Office Managers to facilitate corrections that cannot be processed internally.
- Verify correct coding to support prompt payment and input accurate billing information for Team Leader review.
- Create patient files so offices can contact the patient and deliver the product.
- Review Proof of Delivery (POD) packets to confirm accuracy for reimbursement.
- Process fulfilled patient orders after validating and documenting any discrepancies in the EMR.
- Learn and apply OHI (Other Health Insurance) rules, including the effect on the patient and billing and the steps to verify OHI.
- Stay current on TRICARE and Humana Military billing changes through ongoing training.
- Support billing and compliance requirements in accordance with Medicare, HIPAA, and other governmental regulations.
- Ensure compliance with company policies, safety standards, and healthcare regulations.
Qualifications
- A High School Diploma or GED.
- Excellent written and verbal communication skills.
- Strong organizational, research, and problem-resolution skills.
- Ability to multitask, prioritize, and work independently in a fast-paced environment.
- Comfort working with numbers and processing financial information.
- Ability to navigate multiple internet-based and billing applications.
- Preferred Certification in Medical Billing (CMRS or equivalent).
- Six months of experience in a healthcare setting, medical office, sports rehab, fitness, or retail environment.
- Experience with billing software or an EMR system.
- Military service, military spouse, or familiarity with military communities.
Pay
$18.00–$28.00 per hour based on experience, qualifications, and location.
Benefits & Incentives
- Medical, Dental, and Vision Insurance.
- 401(k) Retirement Plan.
- Paid Time Off (PTO).
- Paid Holidays.
- Sick Leave.
- Professional Development Opportunities.
- Employee Recognition Program.
- Certification Bonus Program.
Career Advancement
Tactical Rehab is committed to promoting from within. Employees who demonstrate exceptional performance and obtain professional certifications may advance into higher-level documentation, billing, and leadership roles.
Veteran-Friendly Employer
Veterans, transitioning service members, military spouses, and military family members are strongly encouraged to apply.
Apply Today
If you are passionate about helping others and want to build a career with a company that values service, teamwork, and professional growth, we would love to hear from you. Tactical Rehab — Restoring Mobility. Improving Lives. Supporting Those Who Serve.