What are the responsibilities and job description for the Documentation and Claims Specialist position at Volare Health, KY?
Volare Health, LLC is seeking a Documentation and Claims Specialist to manage and coordinate responses to Additional Documentation Requests (ADRs) from Recovery Audit Contractors (RAC), Medicare Administrative Contractors (MAC), and Managed Care entities for Skilled Nursing (SNF) and Long-Term Care (LTC) Facilities. This role involves collaborating with facility teams, corporate compliance, and billing departments to ensure accurate and timely documentation submissions, proper reimbursement, and adherence to federal and state regulations.
Here at Volare Health, LLC, we operate long-term care skilled nursing and short-term rehabilitation centers across multiple states. At our company, we extend a warm welcome to our residents, their families, and our dedicated staff.
Schedule: Full-time
Pay: $50,000/YR (Salaried)
Key Responsibilities:
- Track and manage ADRs from RAC/MAC and Managed Care payers, working with facility teams to gather and submit documentation.
- Review and follow up on claims for accuracy, resolve denials and discrepancies, and ensure compliance with payer requirements.
- Act as a liaison between the corporate office and facilities to ensure smooth communication regarding ADRs and claims.
- Ensure submissions meet regulatory requirements, maintain accurate records of ADR responses and claim follow-ups, and assist with audits.
- Provide training to facility staff on ADR processes and documentation requirements, staying current on CMS and payer policies.
Requirements:
- Minimum of 3 years' experience in healthcare reimbursement, including ADR, RAC/MAC audits, and Managed Care claims.
- Strong knowledge of Medicare, Medicaid, and Managed Care billing and reimbursement policies.
- Previous experience in Skilled Nursing or Long-Term Care setting is a plus!
Benefits and Perks:
- We offer comprehensive benefit (Health, Dental, Vision) packages with options for you and your family.
- Career Advancement
- Company-Paid Life Insurance
- Flexible Spending Account (FSA)
- Health Savings Account (HSA)
- Paid Time Off (PTO)
- Tuition Reimbursement
Salary : $50,000
