Detail-Oriented Clinical Documentation Specialist

2 weeks ago

Imus, Calabarzon, Philippines beBeeClinicalDocumentation Full time $41,088 - $43,840
Job Opportunity

We are seeking a detail-oriented Clinical Documentation Specialist to support our Residential, PHP, and IOP levels of care.

This individual will be responsible for conducting clinical documentation reviews, case consultations, and interfacing with insurance payers to obtain continued authorization.

Key Responsibilities:
  • Conduct thorough clinical documentation reviews and provide detailed feedback to healthcare professionals.
  • Review comprehensive client charts prior to documentation reviews, including progress notes, psychiatric evaluations, history and physical exams, nursing assessments, medical vitals, and lab reports.
  • Collaborate with healthcare teams to gather updated information that supports clients' medical necessity for continued care.
  • Maintain a working knowledge of insurance medical necessity criteria (e.g., ASAM, MCG, InterQual).
  • Accurately document all interactions in designated systems.
  • Participate in interdisciplinary team meetings and provide feedback on documentation practices that support utilization review.
  • Proactively track authorization timelines, expirations, and upcoming reviews to avoid service interruptions.
  • Ensure adherence to HIPAA, ethical standards, and payer requirements during reviews and documentation.
Required Qualifications:
  • Licensed Registered Nurse (RN) or equivalent experience in behavioral health.
  • Minimum 2 years' experience in behavioral health, substance use, or psychiatric care.
  • Prior experience with utilization review, case management, or insurance authorization processes is an asset.
  • Familiarity with insurance platforms and payer-specific guidelines.
  • Excellent communication skills with the ability to represent clinical information clearly and persuasively.
  • Strong attention to detail and ability to work independently and under pressure.
Benefits:
  • Full-time remote opportunity
  • Mid-senior level position
  • Administrative job function
  • Hospitals and Health Care industry

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