Documentation and Compliance Associate

Clinical Documentation & Revenue Integrity Coordinator

• Review and score Behavioral Health Technician (BHT/RBT) progress notes using approved fidelity rubrics
• Review Behavior Consultant (BC) service notes ( 97156) with supervisory guidance
• Ensure all documentation meets regulatory payer and organizational standards
• Identify documentation gaps errors and inconsistencies that may impact billing
  • Evaluate notes against established fidelity benchmarks and scoring criteria
• Communicate required corrections and action items to improve documentation quality and compliance
• Provide rubric-based feedback and recommended revisions when documentation scores fall below established thresholds (e.g. 80%)
• Accurately document and track all reviews in a timely manner
• Monitor tracking systems to ensure timely completion and quality of progress notes
• Support claims reviews and appeals by verifying documentation is complete and compliant
• Partner with billing and clinical teams to resolve documentation-related denials
• Support CR Help by updating client records including session notes end times and place-of-service details
• Audit non-billable time entries in CR to ensure accuracy
• Coordinate insurance pre-authorizations and appeals for ABASS services by gathering required documentation preparing submission materials and supporting participation in the appeals process
  • Maintain a reference library of supporting literature for appeals
  • Collaborate with internal teams and payer representatives to facilitate timely resolution of authorization requests and denials
• Maintain accurate and up-to-date data across all documentation and tracking systems
• Provide administrative and operational support across departments as directed
• Support special projects and company initiatives as assigned
  • Maintain current knowledge of payer policies and guidelines across all contracted plans
  • Develop and maintain a centralized reference of payer policies guidelines and updates
• Perform additional duties as needed to support organizational operations