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