HCA Admin Asst - Doc/Reimb Verification

Education : High school diploma or equivalent required.

Experience : Administrative, healthcare, homecare, medical records, billing, or documentation experience preferred. Experience with electronic health records or scheduling systems preferred. At least 1 years experience working with the frail elderly population.

Number and Type of Employees Supervised (optional) : None.

Licensure, Registry or Certification Required : NC drivers' license.

Special Training : Be knowledgeable in multiline computer operations and phone systems as well as excellent writing and reporting skills. Be competent in the use of Microsoft office software-specifically Outlook, Excel, PowerPoint, and Word. Meet a standardized set of competencies for the specific position description established by Senior TLC, Inc. and approved by CMS before working independently.

Adult/ Geriatric

· Review daily aide service documentation for completeness and accuracy.

· Verify that required services and tasks are documented appropriately.

· Confirm that required participant signatures or acknowledgments are present when applicable.

· Review clock-in and clock-out information for consistency with scheduled services and documentation.

· Identify missing, incomplete, late, or inconsistent documentation.

· Verify that documentation supports the services reported for reimbursement.

· Compare schedules, visit records, task documentation, and other applicable records for discrepancies.

· Follow up with appropriate staff when corrections or clarification are required.

· Maintain a tracking system for outstanding documentation issues.

· Review housekeeping documentation to ensure required services are documented.

· Verify that housekeeping tasks are clearly and accurately recorded.

· Ensure documentation reflects the exact services scheduled and authorized.

· Identify missing signatures, incomplete task documentation, or other deficiencies.

· Communicate corrections needed to aides or supervisory staff.

· Monitor outstanding housekeeping documentation until resolved.

· Review documentation for completeness and consistency before submission for reimbursement.

· Ensure documentation contains the information required by agency policies and applicable payer requirements.

· Identify documentation that may prevent a service from being submitted for reimbursement.

· Escalate questionable, conflicting, or potentially inaccurate records to the supervisor or appropriate department.

· Assist with maintaining organized records supporting billed services.

· Maintain documentation according to agency retention and confidentiality requirements.

· This position does not independently determine Medicare coverage or billing eligibility unless specifically authorized and trained to do so.

· Send reminders regarding missing or incomplete documentation.

· Maintain strict confidentiality of participant, employee, medical, financial, and agency information.

· Follow HIPAA and agency privacy and security policies.

· Access only information necessary to perform assigned duties.

· Use only agency-approved devices, systems, email, and communication platforms.

· Protect passwords and other login credentials.

· Immediately report suspected privacy, security, or documentation concerns to the appropriate supervisor.

· Supports Senior TLC’s mission to encourage and support the quality of life of seniors wishing to continue living in the community; its vision to be the preferred provider of individualized care for seniors in the community; and its values of respect, integrity, accountability, compatible goals, and compassionate care.

· Other duties as assigned.