Job Description

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.

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