Clinical Support Specialist bei AcTion Seating & Mobility
AcTion Seating & Mobility · Denver, Vereinigte Staaten Von Amerika · Onsite
- Professional
- Optionales Büro in Denver
Description
Department: Operations (CRT) | Reports to: Branch Manager & ATP Manager
Type: Full-time (On-site with limited local travel)
Pay: $24-26 per hour
Business Hours: Monday-Friday 8a-5p
Why this role matters
At Action Seating & Mobility, we help people with complex medical needs gain independence through Complex Rehab Technology (CRT). As a CSS, you’re the coordination hub for therapists, ATPs, payers, and clients—making sure documentation is right, authorizations get approved, and orders move. Your accuracy and follow-through directly impact how fast someone gets life-changing equipment.
What you’ll do (core outcomes)
- Authorization success & speed
- Prepare complete funding packets and submit within target timeframes (e.g., = 5 business days after final clinical docs).
- Track decisions; proactively close gaps to reduce rework/denials.
- Documentation quality
- Review LMNs, PT/OT evals, and physician notes for payer compliance; request corrections/clarifications quickly.
- Maintain low doc-error rates (goal set by branch leadership).
- Case flow & communication
- Own updates to clients, therapists, and ATPs; respond to messages within 1 business day.
- Keep EMR (Atlas) and trackers current so the team always knows status.
- Order readiness
- Generate accurate quotes; route clean orders to Purchasing with correct codes, documentation, and delivery notes.
- Escalate barriers early (clinic delays, missing signatures, payer nuances).
- Quality & compliance
- Follow HIPAA/PHI safeguards; be audit-ready at all times.
- Stay current on CO Medicaid and commercial documentation rules.
Requirements
Day-to-day responsibilities
- Partner with assigned ATP(s) to move cases from eval ? docs ? funding ? order submission.
- Validate clinical notes/LMNs against payer criteria (Medicare, Health First Colorado/Medicaid, and major commercial plans).
- Build and submit prior auths; maintain payer portals and decision logs.
- Create quotes; verify codes and coverage; flag non-covered items for ABN/waiver.
- Maintain clean, timely documentation in Atlas and standard branch trackers.
- Coordinate schedules with clinics/clients; support evaluation and delivery logistics (communication only).
- Provide courteous, proactive updates to clients, clinics, and internal teams.
- Contribute to branch huddles; suggest workflow improvements.
- Support onboarding of new CSS staff with tips/checklists once proficient.
What you bring
- 1+ year in CRT/DME, therapy clinic admin, payer authorization, or similar healthcare coordination.
- Working knowledge of payer documentation standards for CRT (Medicare, Medicaid, commercial).
- Strong organizer: can juggle 30–60 active cases while hitting deadlines.
- Clear, professional communicator; confident asking clinics for doc fixes.
- Systems: EMR/CRM (Atlas preferred), Microsoft 365/Google Workspace; comfortable with payer portals.
- Confidentiality mindset; HIPAA/PHI literate.
- Occasional local clinic visits; routine lifting limited to standard office needs.
Nice to have
- Prior CRT exposure (ATP workflows, LMN elements, wheelchair/seating terminology).
- Spreadsheet chops (filters, lookups, basic pivoting) for trackers and reports.
- Experience with CO Medicaid and regional MCO requirements.
What we offer
- Competitive pay, medical/dental/vision, 401(k), life Insurance.
- Training on payer rules, documentation quality, and Atlas best practices.
A mission-driven team that values accuracy, urgency, and client dignity.