Job Information
Diversicare Healthcare Services & Diversicare Ther Denials and Appeals Specialist in Brentwood, Tennessee
Overview
Smile, You’ve Found Us!
Remote position, LPN or RN, experience with MDS required
Are you passionate about caregiving? Would you like to work with the best team in the world? If so, Diversicare invites you to apply.
We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence, which we extend to all those we are privileged to serve.
If you wish to make a difference in the lives of our patients and residents, APPLY NOW!
Full Time Benefits include:
Medical/Dental/Vision
Excellent 401k plan
Tuition Reimbursement
Vacation, Holiday, and Sick Time
Long and Short Term Disability
Employee Assistance Program
Life Insurance
Referral Bonuses
DiversICARE - employee hardship fund
Pay advancement program - OnShift Wallet
Diversicare provides post-acute care services to patients and residents at 45 skilled nursing and long-term care centers in eight states, primarily in the Southeast, Midwest and Southwest United States. Together, with our team of dedicated healthcare professionals, we leverage our diverse strengths to provide each patient and resident with healthcare serves that best meet their needs.
It is Diversicare’s Mission to “Improve every life we touch by providing exceptional healthcare and exceeding expectations.”
We are guided to excellence by five Core Values: Integrity, Excellence, Compassion, Teamwork and Stewardship, as well as 12 Service Standards.
We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence. Our Service Standards are in place to offer support. They lead us to what matters most to our company: creating a warm, caring, safe and professional environment for our customers and each other.
Our culture of impassioned service delivery is the Diversicare Difference .
#BSC123
Responsibilities
Maintain an electronic tracking system for all ADRS, denials, and appeals.
Communicate and collaborate with centers to ensure timely responses to all claims.
Submit ADR documentation
Write redetermination letters.
Follow each claim through each level of determination until resolved.
Scheduled and assist with ALJ hearings
Maintain relationships with all fiscal intermediaries, MACS, CHS, insurance companies and any
other agencies as needed.
Maintain knowledge of trends and changes in ADR, denial and Appeal process.
Prepare and gather records for outside reimbursement audits.
Qualifications
Current nursing license by state board of nursing (RN or LPN) or related Healthcare field
Experience in SNF/LTC
Experience in Clinical Software Systems
Experience in minimum data set.
(EOE)
Job ID 2024-58468
Type Regular Full-Time
Location Name Diversicare Support Center(BSC)
Shift Days
Address 1621 Galleria Blvd
Location US-TN-Brentwood