AUDIT AND APPEALS TECHNICIAN in Clinton, North Carolina at Liberty Health

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We are currently seeking an experienced:

AUDIT AND APPEALS TECHNICIAN

JOB SUMMARY:

• Review Audit & Appeals Manager, Humana and other e-portals regularly for new ADR requests.
• Assist the SNF ADR & Appeals Nurse with sending/following up on requests as necessary to facilities and offices as assigned
• Monitor due dates to ensure that facility-required documents are returned to Corporate timely for processing and follow up with facilities/offices if late to ensure records arrive for processing.
• When records arrive via email, the Audit and Appeals Technician will review the records to make sure they are in order per slip sheets and that key components are in the records and contact facility if anything is missing to make sure that it is sent in ASAP.
• Audit and Appeals Technician will print out the department-required documents and combine with the facility documentation returned, ensuring that each section is behind the appropriate slip-sheets.
• Once the record is finalized, it will be sent to the ADR & Appeals Nurse for a comprehensive review.
• Once the comprehensive review is completed by the nurse, the record will be returned to Audit and Appeals Technician who will scan the documents for processing.
• The scanned documents are then to be saved on the Liberty common drive in the appropriate folder and notification is made to the ADR and Appeals Nurse that they are completed.
• If the record cannot be submitted electronically, The Audit and Appeals Technician will mail out in a timely fashion after the ADR & Appeals Nurse has reviewed and signed off as complete.
• An electronic copy of all records will be kept for all submissions on the Liberty intranet/common drive.
• Paper copies of the submitted records will be stored as directed in an organized manner as they may be needed should an ADR deny and go to an appeal level.
• Paper copies of records will be reviewed quarterly to determine if they can be shredded or may still be needed. This will be done in coordination with and under the direction of the ADR & Appeals Nurse
• ADR & Appeals nurse will also assist with and complete various records audits as requested/directed by the Senior Director, Reimbursement Appeals and/or the ADR and Appeals Nurse.

JOB REQUIREMENTS:

• Requires a high school diploma or equivalent and 2 years’ prior experience in an office setting.
• Proficient in keyboarding
• Experience with Microsoft Office and Adobe Acrobat Pro preferred
• Ability to learn and understand various clinical software applications – Including EHRs – such as Point click Care, AXXESS, Net Health, Waystar applications and others as necessary.
• Ability to operate office equipment such as copiers, scanners, computers, memory storage devices, etc.
• Strong deductive reasoning and multitasking ability
• Self-motivation and ability of working independently with limited supervision and structure in a fast-paced environment
• Ability to manage multiple projects/multi-task simultaneously, as needed, and meet set deadlines.
• Excellent organizational skills
• Excellent interpersonal, verbal, and written communication skills
• Must have a valid drivers’ license

Visit www.libertycareers.com for more information.
Background checks/drug-free workplace.
EOE.