A Compensation or Benefits Specialist evaluates and works to maintain the pay structure and benefits program at an organization. Analyzes wage and salary data and trends, monitors market conditions; works with benefits vendors, processes benefit claims for employees; monitors government employment regulations. May focus specifically on job classifications and compensation or on benefits programs such as pensions.
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! Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
