ADR Coordinator & Clinical Compensation Specialist | Hybrid

Job Description

Job Description

Position Summary:

ADR Coordinator oversee the response process on behalf of assigned HCF Care Communities for any appeal, review or denial of pre/post payment for services provided.

Position Responsibilities:

* Coordinates the response process on behalf of assigned HCF Care Communities for any appeal, review or denial of pre/post payment for services provided.

* Researches medical records, prepares documents, and generates ADR and appeal responses to CMS or other 3rd party payers.

* Analyzes the initial documentation/billing processes to determine necessary changes to avoid future appeals, reviews or denials.

* Collaborates with Billing department, Regional Nurses, Therapy vendor and other resources to establish a system resulting in a reduction of appeals and reviews for submitted claims.

* Provides appropriate education to employees to ensure processes are in place to avoid future denials.

* Ability to travel to assigned HCF Care Communities as necessary based on ADR, appeals, and review activity.

Knowledge, Skills and Abilities: Licensed Practical Nurse in State of Ohio (Registered Nurse preferred); 3 years’ experience in Long-term care field. MDS or Case Management experience is necessary.

Benefits for

* Promotion opportunities

* Flexibility

* Education/Learning

* Competitive benefit package

What we look for in

Experience – If you’ve had a job or experience in a position with similar goals and responsibilities, we’d love to connect with you.

Skills – We’re looking for individuals that are compassionate, team players, social, trustworthy and service-minded.

Characteristics – We’re looking for individuals that are self-motivated, dependable, ethical, and ready to jump in and provide outstanding care and customer service to our residents.

The Company

Our Core Values, better known as We Care is that each and every employee in the organization is held to standards of Wholeheartedness, Excellence, Collaboration, Accountability, Respect, and being Ethical. Whether you work for HCF or become a resident of HCF, we can promise you one thing; we will treat you like family!