Clinical Documentation & Provider Success Specialist
On-siteDenver, Colorado, United States
Job Summary
Review clinical documentation for completeness, accuracy, and payer compliance to identify gaps impacting reimbursement or patient care. Partner directly with physicians, nurses, therapists, and field sales representatives to obtain required documentation, communicate deficiencies, and resolve barriers affecting onboarding. Interpret payer policies and internal standards to ensure medical necessity requirements are met while maintaining HIPAA confidentiality and accurate tracking. Collaborate with Revenue Cycle, Operations, and Compliance teams to support continuous improvement initiatives and reduce denials. Requires four years of healthcare documentation experience, strong medical terminology knowledge, and proficiency with EMR platforms. Success is measured by improved documentation quality metrics, reduced delays, and efficient resolution of customer-facing issues.
Required Qualifications
- High school diploma or equivalent
- Associate's degree or coursework in Health Information Management, Medical Coding, Healthcare Administration, or related field
- Four (4)+ years of progressive experience supporting healthcare documentation, provider services, revenue cycle operations, medical office operations, billing, coding, durable medical equipment, home health, or similar healthcare environments
- Strong understanding of medical terminology
- Experience working directly with providers, clinical staff, customers, or healthcare partners
- Working knowledge of payer documentation requirements and reimbursement workflows
- Excellent written and verbal communication skills
- Strong organizational skills with exceptional attention to detail
- Experience utilizing EMR platforms, documentation systems, CRM tools, and Microsoft Office
Desired Qualifications
- Knowledge of ICD-10, CPT, HCPCS, prior authorization documentation, or payer medical policies
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.