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Medicare ADR Specialist

4 months ago

Toledo, United States ProMedica Health System Full time

Responsible for Daily Review of outstanding and incoming Medicare Additional Development Requests (ADRs).

Responsibilities:
1. Maintains updated files as changes occur
2. Manages specialized ADR computer software
3. Provides office support and training as needed on ADR computer software
4. Gathers information from Home Health & Hospice offices
5. Answers questions offices have regarding Medicare denials
6. Processes Medicare Additional Development Request
7. Researches payments that do not match billing
8. Reviews suspended, denied, or rejected claims for reason of non-payment, makes necessary corrections to be re-submitted
9. Prints accounts receivable reports for review
10. Performs filing as appropriate in a timely manner
11. Reviews all appropriate documentation with A/R Supervisor
12. Communicates with field offices as needed to obtain information required to complete tracking logs
13. Contacts responsible party to make collections of outstanding receivables
14. Attends and participates in scheduled in-service programs and staff meetings
15. Maintains confidentiality of necessary information
16. Utilizes supplies and equipment properly and without waste
17. Thinks and acts calmly and logically to meet unusual occurrences of the job without being thrown off stride
18. Performs any miscellaneous work assignments as may be required
19. Meets all requirements of the Billing/Collections Responsibility Checklists for daily, weekly & monthly processes.

::
1. Education: High School plus additional specialized business courses equal to one to three years training in accounting or bookkeeping
2. Experience: One to three year billing, accounting, or business experience with and third party billing experience preferred. Medicare experience required.
3. Physical Demands: Work is primarily sedentary in nature with exerting up to lifting 10 lbs. of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body. Involves sitting, kneeling, crouching, reaching, handling, fingering, talking, hearing, near visual acuity, and visual accommodation
4. Travel: 10%

ProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org

Equal Opportunity Employer/Drug-Free Workplace

**Requisition ID:** 83324