Since 1852, Elwyn has helped people with autism, intellectual, developmental, and behavioral challenges lead meaningful lives. As an internationally recognized nonprofit human services organization, we have always been on the forefront of innovation.

Please join us to make a difference in the life quality of children, teens and adults with autism, intellectual and developmental disabilities, and related behavioral health challenges - and feel the resulting pride that will enrich your own life.

• Generous Paid Time Off
  
• Comprehensive Medical/Dental/Vision Benefit Packages
  
• Earned Wage Access/On-Demand Pay
• Paid On-the-Job Training
  
• Tuition Reimbursement
  
• Career Advancement Opportunities and Growth
  
• Flexible Schedules
  
• Retirement Savings Plan

Elwyn is currently seeking a Documentation Specialist to review documentation related to service delivery. This position reviews submitted progress notes and ensures all documentation meets Medicaid standards for billing. The Documentation Specialist provides support to the programs on their caseload to allow for constructive feedback on documentation to be applied to performance improvement measures on behalf of the program leadership.

DUTIES AND RESPONSIBILITIES:

• Performs internal reviews to investigate and monitor compliance with federal and state laws and regulations, Medicaid, billing guidelines, Health Insurance Portability and Accountability Act (HIPAA) Privacy Standards, and Electronic Health Records (EHR) Best Practices
• Works closely with the Electronic Health Records Manager and Utilization Specialist to provide consistent reporting on status of program billing issues and concerns, ensuring adherence to all third party payer requirements, protocols and best practices
• The Documentation Specialist acts as a liaison between program leadership and the billing approval process to ensure non-billable claims are tracked and rectified in an efficient manner
• Participates in and represents the EHR Department on applicable committees to maintain appropriate business standards, including taking the lead in the development of internal controls to monitor adherence to applicable statutes
• Maintains awareness of compliance, privacy and documentation laws and industry developments pertaining to reimbursement, Medicaid compliance and applicable state and federal requirements for organizations as defined in the Community Care Program Manual
• Develops and utilizes electronic trackers or other tools to facilitate streamlining of day-to-day operations and data analyses at the discretion of the Electronic Health Records Manager in conjunction with Operational Leadership, including but not limited to on-site support at programs coordinating accurate recording of data such as attendance and service times
• Compiles and summarizes data and assists in preparing reports and/or analyses related to the results of audit/review observation
• Facilitates ongoing electronic health records training within assigned programs with focus on empowering program management to include electronic documentation in overall performance evaluation and counseling for supervisees; this includes but is not limited to timely submission of documentation that supports the services provided for claims reimbursement
• The Documentation Specialist works with direct supervisor to facilitate and assist with the ongoing electronic documentation training as needed for assigned members of the organization
• Supports Operations with performing on-site assessments of staff engagement utilizing methods developed by Quality Improvement and other applicable departments
• Maintains current state-mandated training and certifications
• Follows all current policies and procedures of Elwyn New Jersey
• Cooperates with Elwyn New Jersey and the State of New Jersey Department of Human Services, or any other authorized investigating body during an inspection, inquiry, or investigation
• Performs other duties as assigned at the discretion of direct supervisor and Executive Director

QUALIFICATIONS, EDUCATION AND EXPERIENCE:

• Associate degree in healthcare or related field; equivalent combination of directly relevant experience in quality assurance, utilization review, billing, or related area and education may be substituted
• Certification in Healthcare Compliance (CHC) is a plus
• Knowledge and experience in home and community-based services preferred
• Demonstrated excellent analytical and problem-solving skills, and judgment with specific application to medical and financial data
• Previous experience in state and government contracts preferred
• Demonstrated ability to effectively work equally on a team and independently
• Ability to work in a fast-paced environment and manage and prioritize multiple, often competing, priorities
• Demonstrated strong attention to detail and capacity to relate to scope of obligations
• Demonstrated strong time management and organizational skills
• Demonstrated excellent judgment with the ability to independently solve problems and make decisions or recommendation for change with little or no need for direct supervision
• Must possess excellent written and verbal communication skills that foster effective collaboration and presentation
• Demonstrated intermediate working knowledge with Microsoft Office applications, including Word, Excel, and Outlook
• Experience using/knowledge of Electronic Health Record (EHR) / Electronic Medical Record (EMR) preferred
• Must submit to a criminal background check and drug test and be determined to be not disqualified by the New Jersey Department of Human Services prior to working with individuals served
• Must agree to have their name checked against the New Jersey Central Registry of Offenders Against Individuals with Developmental Disabilities and NJ Child Abuse Registry (CARI).
• Must have current, valid driver's license in state of residence, three (3) years driving experience in the United States, and acceptable driving record