Therapy Documentation and Appeals Coordinator - Part Time

Therapy Documentation and Appeals Coordinator
Appeals Experience Required

MediLodge seeks a top-notch Therapy Documentation and Appeals Coordinator who has a strong work ethic, exceptional organization skills, attention to detail, and the desire to acquire and apply new skills within our fast-paced environment. This position will work closely with our internal ADR team and reports to the ADR Director.

Summary: The Therapy Documentation and Appeals Coordinator works with the ADR team and is responsible for data collection and submissions, writing and filing appeals, tracking, denial management, and documentation compliance.

Qualifications:   Education:

• Bachelor's Degree Required or equivalent specific experience in skilled nursing with ADR teams.

Licenses/Certification:  N/A   Experience:

• 2+ years in accounting and/or finance
• Healthcare ADR experience

Key Responsibilities:

• Data Collection & Submission: Coordinates and gathers all necessary supporting clinical information (medical records, assessment documentation , physician notes, pre auth info) and billing documentation to build strong appeal cases and works directly with ADR team and Therapy  departments to ensure a seamless process and submission timelines are met. 
• Writing & Filing Appeals: Assists with the Drafting  and submission of detailed appeal letters and data to insurance companies and third  party reviewers.
• Follow-Up & Tracking: Manages phone calls, monitors appeal status, communicates effectively with the Select Rehab and Prestige teams and ensures all deadlines are met.
• Denial Management: Reviews insurance denials, identifies trends, and works to resolve them.
• Coordination: Liaises with clinicians, coders, physicians, Therapy and HIM (Health Information Management) departments.
• Compliance: Ensures all activities and documentation meet regulatory and payer guidelines. 
• Other tasks as assigned.

Knowledge/Skills/Abilities: 

• Expert in MS-Excel
• Ability to learn new skills and operate in a dynamic environment
• Ability to function as part of a team
• A customer service attitude and work ethic, responsive
• Attention to detail
• Ability to communicate effectively with all levels of the organization.
• Ability to maintain confidentiality of all information