Heather Haberhern, Otr/L, Rac-Cta, Qcp Email & Phone Number

Chattanooga, Tn, Us

Woodmere, New York, United States

Hill Valley Healthcare operates Skilled Nursing Facilities, Assisted Living Facilities and Home Health companies across the nation. As the Corporate Director of Clinical, I support our regional teams and the communities in coding the MDS accurately to capture the services provided and the conditions presented by our resident to ensure appropriate reimbursement for both PDPM and Medicaid CMI. Initiating and leading processes to ensure accurate payment, coding, documentation is a primary role within Clinical Reimbursement. Education and training is also a key to success and is completed in conjunction with other team members at Hill Valley Healthcare.

Chattanooga, Tennessee, United States

My goal is ensuring compliance of rehab partners with Medicare Regulations by reviewing and analyzing documentation to support skilled services provided to maintain revenue integrity of services billed. With the payment changes to the Patient Driven Payment Model, I provide ongoing education and training to our communities and rehab partners to continue the successful transition. Using data analysis of metrics, I am able to determine areas of potential weakness in documentation and work to improve those areas to ensure appropriate payment. Program development is also a part of my role, most recently developing the Restorative Nursing Program for our company. Overseeing the appeals and denials process to ensure we receive payment for services rendered is also a key component to my role at Grace Healthcare and I take pride in ensuring favorable decisions from our payers. Training and education is a passion and I enjoy researching information and best practices to share with our teams and clinicians to ensure the highest quality of care is delivered in our communities.

Chattanooga, Tennessee, United States

Promotional progression from Regional Rehab Director to Vice President of Clinical Services for 21 communities. Consulting and managing multiple rehabilitation departments in skilled nursing facilities which have been transitioned from contract company managed departments to an in-house rehabilitation model. Managed the appeals and denials of claims for Medicare and Managed Care payers from the Additional Development Request (ADR) phase to the Administrative Law Judge (ALJ) level to ensure appropriate capturing of reimbursement for services delivered. Significantly improved regional and company financial performance through program development and operational performance. Real-Time knowledge of reimbursement and regulatory requirements.Developed and implemented programs to address the needs of the facilities in which we served, including Denials Management, Falls Reduction, Dementia Programming, chart audits and documentation/screening programs. Transitioned, implemented and trained employees on utilization of new documentation system and software program.

Chattanooga, Tennessee, United States

• Developed and managed rehab department for 120 bed skilled nursing facility• Improved services delivery through staff development, case management, utilization of modalities and enhanced procedures, and development of streamlined documentation procedures. • Developed and implemented a successful, comprehensive denials management program resulting in significantly improved reimbursement for services. • Significantly improved facility financial performance through program clinical development, operational performance, and denial appeals management.• Maintained high efficiency rate for all clinicians over 80%

Worked as an OT in a multiple clinic outpatient rehab setting to evaluate, determine plan of care, and treat patients having upper extremity orthopedic and/or neurological limitations. Other responsibilities included: the utilization of treatment modalities for increasing function; partnered with case managers to ensure highest quality of care and ongoing progress with patients; facilitated and built relationships with referring physicians and nurses to maintain continuity of care.

B.S., Occupational Therapy

B.S., Human Ecology: Food And Nutrition