ADR Coordinator & Clinical Compensation Specialist | Hybrid

Coordinate the response process for assigned HCF Care Communities regarding appeals, reviews, or denials of pre/post payment for services. Research medical records, prepare documents, and generate ADR and appeal responses to CMS or other third-party payers. Analyze initial documentation and billing processes to determine necessary changes that avoid future appeals and reviews. Collaborate with the Billing department, Regional Nurses, Therapy vendors, and other resources to establish systems reducing claim denials. Provide appropriate education to employees to ensure processes remain in place. Ability to travel to assigned HCF Care Communities as necessary based on ADR, appeals, and review activity. Requires Licensed Practical Nurse in Ohio with three years in long-term care.