Clinical Documentation Specialist

Salary: $69,500 - $86,500 / year At PRC-Saltillo, our mission to provide voices to children, teens, and adults who are unable to communicate effectively with their natural voices. Each year, we provide voices to thousands of individuals through our specialized communication devices, software, and apps. We serve individuals with autism, cerebral palsy, Down syndrome, ALS, aphasia, and a variety of other medical conditions. Our products not only provide the ability to speak, but open opportunities for education, employment and fuller participation in life. All applicants need to go to our website to applywww.prc-saltillo.com/careers Position Summary: The Clinical Documentation Specialist provides expert guidance to Speech-Language Pathologists (SLPs) and AAC Consultants throughout different points of the funding process for medical speech-generating devices (SGDs). This role delivers targeted education on evaluation report writing, ensuring alignment with Medicare, Medicaid, and payer-specific requirements, and conducts thorough reviews to promote documentation accuracy and compliance. Strategically, the role collaborates across departments to drive process improvements, proactively address adverse determinations, and supports appeals and prior authorization efforts. By analyzing outcomes and sharing best practices, this position advances organizational goals for customer satisfaction, optimizes workflow and tools, and fosters clinician development while maintaining regulatory excellence. Duties and Responsibilities:

• Leads comprehensive reviews of all Medicare-required SLP evaluation reports and related documents, ensuring compliance with coverage criteria for SGDs and accessories, clearly communicating recommended changes to SLPs, AAC Consultants, and funding staff.
• Completes targeted documentation reviews for other funding submissions as required by internal criteria to address specific funding-source or billing concerns, to optimize first-pass approval rates, maintaining regulatory compliance, and ensures successful billing.
• Designs and delivers education and coaching both individual and group based to SLPs and AAC Consultants, focusing on best practices and requirements of SGD evaluation report writing standards. Provides expert guidance, real-time feedback, and support through virtual sessions designed to address specific clinical scenarios.
• Develops, implements, and evaluates professional development programs and educational resources that build long-term competency in SGD clinical report writing, fosters best practices, and supports ongoing organizational growth within the organization.
• Monitors, researches, and disseminates the latest SGD policy updates and best practices for report writing across all relevant funding sources.
• Engages in the internal peer reviews and adverse determination process to support documentation quality and overturn denials.
• Monitors and analyzes documentation trends, approval rates, and coaching effectiveness to inform and refine standardized, data-driven workflows. Collaborates with internal departments to address systemic funding issues, streamline documentation processes, and ensures ongoing alignment with industry best practices and regulatory standards for optimal customer outcomes.
• Performs other duties as assigned.

Required Skills/Abilities:

• Exceptional verbal and written communication skills, with the ability to tailor messaging for different people and communication styles.
• Strong analytical and problem-solving skills, including the ability to research, synthesize, and present complex funding and compliance information.
• Demonstrated attention to detail, especially in clinical documentation and payer criteria.
• Highly organized with effective time management skills to manage coaching sessions, reviews, and collaborative projects.
• Proven ability to work independently and remotely, with flexibility to adapt to rapidly evolving funding guidelines and/or team priorities.
• Proven ability to collaborate to achieve a shared goal.
• Creative thinker with a proactive approach to process improvement and customer support.
• Proficient with Microsoft Office Suite and comfortable using online funding tools and training platforms.

Education and Experience:

• Masters Degree in Speech-Language Pathology is required.
• Minimum of 3 years of progressive experience in the field of AAC or Assistive Technology is required; experience with PRC-Saltillo communication products is preferred.
• Minimum of two years of experience in completing and writing AAC evaluations is required.
• Familiarity with Medicare, Medicaid, and commercial payor guidelines is required.
• Minimum of one year of experience coaching, training, or mentoring others in best practices is required.
• Knowledge of AAC principles and solutions is required.
• Experience leading process improvement initiatives is preferred.

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