Reimbursement Coordinator

Claims Reimbursement Coordinator

This is a hybrid position that requires some weekly onsite work. At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, inclusive and supportive work environment where every team member is valued and empowered to make a difference. Whether you're an experienced professional or just starting your career, we offer opportunities for growth, development, and advancement in a range of roles. Join us in our mission to enhance the well-being of our patients and residents while making a meaningful impact in the communities we serve.

Key Responsibilities

• Record Procurement & Compliance: Retrieve and review medical records using PointClickCare (PCC) and Net Health to ensure all documentation meets State, Federal, and payer-specific requirements. Validate presence of all required elements (e.g., physician signatures, certifications/recertifications, therapy documentation, skilled need support) prior to submission.
• Workflow & Deadline Management: Independently manage and prioritize a high-volume workload of record requests and appeals to consistently meet or exceed strict payer deadlines. Ensure zero missed deadlines for ADRs, audits, and appeal submissions.
• Data Tracking & Lifecycle Management: Accurately track and manage all cases within Waystar, ensuring full visibility into request status, submission timelines, denial outcomes, and follow-up actions.
• Internal Liaison & Issue Resolution: Partner with facility teams (nursing, therapy, MDS, physicians) to obtain missing or corrected documentation quickly. Escalate high-risk or time-sensitive documentation gaps and drive resolution.
• Denial Analysis & Strategic Feedback: Identify root causes of denials related to documentation and provide actionable insights to leadership. Support ongoing denial prevention strategies by highlighting recurring compliance gaps.
• Team Collaboration & Process Improvement: Contribute to team meetings, support reporting initiatives, and recommend workflow improvements to enhance efficiency, accuracy, and turnaround times.

Qualifications

• High School Diploma or equivalent One year of relevant experience required in either in a hospital or nursing home.
• Experience with Medical Record documentation.
• Ideal candidates should possess knowledge of Excel, Microsoft Word, and Google Suite, though this is not required. Training will be provided where needed.
• Ideal candidates should possess knowledge of Waystar, PCC, and Nethealth software, though this is not required. Training will be provided where needed.

Benefits

• Variable compensation plans
• Tuition, Travel, and Wireless Service Discounts
• Employee Assistance Program to support mental health
• Employee Foundation to financially assist through unforeseen hardships
• Health, Dental, Vision, Company-paid life insurance, 401K, Paid Time Off
• Free 24/7 virtual health care provided by licensed doctors for all Anthem medically-enrolled employees and their immediate family members
• On-Demand Pay Program that allows for instant access to a portion of the money you've already earned
• We also offer several voluntary insurances such as: Pet Insurance, Term and Whole Life Insurance, Short-term Disability, Hospital Indemnity, Personal Accident, Critical Illness, Cancer Coverage

Restrictions apply based on collective bargaining agreements, applicable state law and factors such as pay classification, job grade, location, and length of service.

Posted Salary Range USD $18.00 - USD $23.00 /Hr.