Documentation and Claims Specialist

Confidential Posting - Documentation & Claims Specialist (SNF/LTC)A growing multi-state healthcare organization is seeking a Documentation and Claims Specialist to oversee and coordinate responses to Additional Documentation Requests (ADRs) from Recovery Audit Contractors (RAC), Medicare Administrative Contractors (MAC), and Managed Care payers for Skilled Nursing (SNF) and Long-Term Care (LTC) facilities.This role partners closely with facility leadership, compliance, and billing teams to ensure accurate, timely documentation submissions, optimize reimbursement outcomes, and maintain compliance with federal and state regulations.Schedule: Full-time in office in Louisville, KentuckyCompensation: $50,000-$60,000 annually (salaried)Key ResponsibilitiesTrack, manage, and coordinate ADRs from RAC, MAC, and Managed Care entities, collaborating with facility teams to collect and submit required documentation.Review claims for accuracy, monitor denials, resolve discrepancies, and ensure adherence to payer guidelines.Serve as a liaison between corporate and facility teams to facilitate communication related to documentation and claims.Ensure all submissions meet regulatory requirements and maintain organized records of ADR responses and claim follow-ups.Support audit activities and provide education to facility staff on ADR workflows and documentation standards.Stay current with CMS regulations and evolving payer policies impacting reimbursement.QualificationsMinimum of three (3) years of experience in healthcare reimbursement, including ADR management, RAC/MAC audits, and Managed Care claims.Strong working knowledge of Medicare, Medicaid, and Managed Care billing practices.Experience within a Skilled Nursing or Long-Term Care environment preferred.Detail-oriented with strong organizational, analytical, and communication skills.Benefits & PerksComprehensive medical, dental, and vision coverage (employee and family options available)Career growth and advancement opportunitiesCompany-paid life insuranceFlexible Spending Account (FSA)Health Savings Account (HSA)Paid Time Off (PTO)Tuition reimbursementThis is a confidential search for an experienced reimbursement professional looking to make an impact within a collaborative and compliance-focused healthcare environment.

Created: 2026-04-02