Coordinator-Reimbursemnt NonExempt (Full Time)

Job Description

POSITION SUMMARY:
Assists Genesis Healthcare denial management team gathering records containing all items required by State and Federal Regulations for all phases of the appeal process.

Essential Duties and Responsibilities: This includes but it's not limited to:
* Managed assigned work load to ensure that appeals are submitted timely.
* File all patient data upon receipt of the information.
* Create records for new patients and prepare electronic files.
* Ensure all required documentation has been received and in the event they have not must be able to follow-up with field staff to obtain missing records.
* Track all appeals/denials (at each level) through the Denials Database.
* Respond to calls from individuals who have questions about medical records and/or appeals
* Build strong relationships with clients.
* Request additional information as needed for completing the medical record.
* Send complete packet, in appropriate order, back to the appropriate field staff for transmittal to the MAC.
* Photocopy records as needed.
* Maintain the confidentiality of all records.
* Provide feedback to management regarding trends or patterns
* Provide back up for team members
* Actively participate in department meetings, offering suggestion for improvement of processed as well as being receptive to suggestions
* Assist with monthly and quarterly reports as needed
* Performing clerical duties as assigned including copying, faxing, and filing.
* Other duties as assigned.


RESPONSIBILITIES/ACCOUNTABILITIES:
* General understanding of Medicare and DDE system
* Knowledge of the 5 Medicare Appeal Levels
* Knowledge of basic Medicare billing practices in a Skilled Nursing Facility.
* Good written and verbal communication skills.
* Strong analytical, organizational, follow-up and research skills
* Advanced knowledge of MS Office Suite, primarily advanced Excel techniques.
* Proficiency with clerical skills for data entry and computer management.
* Ability to adapt to changing departmental demands
* Ability to meet all scheduled responsibilities in a timely manner
* Ability to cope with rapidly changing priorities.
* Ability to work successfully with minimal supervision
* Ability to work with and adapt to all levels of employees
* Ability to build strong working relationships and good customer service, both in person and over the phone
* Good time management skills
* Performs other duties as requested.


 


CRNE


QUALIFICATIONS:

SPECIFIC EDUCATIONAL/VOCATIONAL REQUIREMENTS:1. High School Diploma2. 1 year relevant experience required in either in hospital or nursing home.3. 1-2 years experience in Skilled Nursing Facility or Hospital Billing.4. 1-2 years experience with claim appeal/denial resolution5. Experience with data entry, spreadsheets and word processing programs.6. This position requires that the employee is able to read, write, speak and understand the spoken English language to ensure the safety and wellbeing of our patients and visitors at the work site when responding to their medical and physical needs.7. Must provide verification of TST (tuberculin skin test) as required by state law and in accordance with Company policy. TSTs will be administered at the work site if required.



Position Type: Full Time
Req ID: 323953
Center Name: Genesis HealthCare