Medicare Documentation Specialist

At Accendra Health, we understand that healthcare is complex, and we’re here to make it easier. We help deliver care beyond traditional settings, making essential products and services more accessible through every stage of life. As part of the care team, our teammates play a critical role in delivering personalized, long-term care for the patients we serve.With deep expertise promoting health outside the hospital and a presence in communities nationwide through our Apria and Byram Healthcare brands, Accendra Health does more than just deliver the essentials.If you’re interested in meaningful work with impact, explore our career opportunities and join us in our purpose of Bringing Care To Life™.This position is Hybrid and will require some in office days.The anticipated pay range for this position is $24 hourlyJob SummaryThe Medicare Documentation Specialist is responsible for reviewing patient medical records against strict Medicare guidelines to determine eligibility, ineligibility, or inability to determine due to missing or insufficient documentation. This role requires strong attention to detail, sound clinical judgment, and effective communication with both external clinic partners and internal sales teams to resolve documentation gaps and support accurate determinations.Key ResponsibilitiesReview and analyze patient chart notes and supporting documentation to assess eligibility in compliance with Medicare guidelines and company policiesAccurately classify cases as eligible, ineligible, or unable to determine due to missing or unclear informationIdentify documentation gaps and proactively contact clinics via phone to clarify or obtain required informationCommunicate eligibility outcomes and documentation needs clearly and professionally to clinic staffPartner closely with internal sales representatives to provide timely updates, clarify requirements, and support case progressionMaintain detailed, accurate records of reviews, outreach efforts, and determinations in internal systemsStay current on Medicare guidelines and internal processes; apply updates consistently in daily workMeet productivity, quality, and compliance expectations while maintaining a high level of accuracyEscalate complex or unclear cases appropriately and contribute to continuous process improvementQualificationsExperience reviewing medical records, chart notes, or clinical documentation (Medicare, insurance, or eligibility review experience preferred)Strong understanding of medical documentation standards and regulatory guidelines (Medicare experience strongly preferred)Excellent attention to detail and ability to interpret nuanced clinical informationComfortable making outbound phone calls to clinics and having professional, sometimes corrective, conversationsStrong communication and collaboration skills with both external partners and internal teamsAbility to work independently, manage multiple cases, and meet deadlines in a structured environmentProficiency with electronic medical records (EMRs) and internal case management systemsExperience working remote roles that require 8 hours of dedicationPreferred SkillsBackground in healthcare administration, nursing, coding, compliance, or utilization reviewExperience working cross-functionally with sales or business development teamsKnowledge of audit, quality assurance, or compliance workflowsExperience working with Microsoft Office tools such as Excel, Word, and Teams#AccendraHealthTeammate BenefitsAs an Accendra Health employee, you have choices to fit your life. Our comprehensive benefits program is designed to meet you where you are — through all of life’s stages. We’ve got you and your family covered with benefits that support your health, finances, and overall wellness.Our Benefits Program IncludesMedical, dental, and vision care coveragePaid time off plan401(k) PlanFlexible Spending AccountsBasic life insuranceShort-and long-term disability coverageAccident insuranceTeammate Assistance ProgramPaid parental leaveDomestic partner benefitsMental, physical, and financial well-being programsIf you feel this opportunity could be the next step in your career, we encourage you to apply.Accendra is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, sex, sexual orientation, genetic information, religion, disability, age, status as a veteran, or any other status prohibited by applicable national, federal, state or local law.Note: Accendra is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at our Company via email, the Internet, or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of our Company. No fee will be paid in the event the candidate is hired by our Company as a result of the referral or through other means.#AccendraHealth