POSITION: PROGRESS NOTE REVIEWER

 

WORK SCHEDULE: Notes submitted by providers to be reviewed within 24 - 36 hours daily.  Limit of note review time is five hours daily. 

 

PURPOSE:  Ensure all note documentation is read daily to assure documentation meets audit, billing, BIRP guidelines; note is reviewed with adequate time for provider correction when necessary, allowing for re-review within designated time frame for approval and locking of note.

 

DUTIES AND RESPONSIBILITIES:

• Read notes daily within the mandated time frame of 24 - 36 hours.

• Delete all incomplete notes that are submitted “to be reviewed”.

• Correct service codes and other note modifiers, insuring that any note modifier discrepancies are corrected and ready for billing.

• Correct spelling and punctuation that helps clarify documentation, including but not limited to spelling of consumer’s name.

• Review document for content noting whether or not content is relevant and/or linked to selected treatment goal, following BIRP guidelines, and documentation is clear, understandable.

• Review for adequate documentation to justify time billed. Clinical notes 90806: two distinct, solid interventions; 90808: three distinct, solid interventions; CSI notes: distinct, solid intervention for every 30 minutes billed.

• Recommend the necessary contractors to the BIRP lab for extra help.

• Attend reviewers meetings as scheduled.

• Mandatory attendance at assigned Team’s meeting once monthly.

• Contact Reviewer Manager, UM of provider with any suspicion of insurance/medicaid fraud.

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QUALIFICATIONS:

• Must have clinical background.

• College degree

• Must have the ability to read large quantity of notes in a timely manner.

• Must submit and pass criminal background check.

• Knowledge of note documentation standards.