Heather Guin

WORK HISTORY

EDUCATION

SKILLS

ABOUT HEATHER GUIN

PTA, RAC-CT, CRC- I am responsible for creating resources to educate our staff therapists, nurses, and customers on techniques for improved documentation, billing, and MDS/ICD-10 coding practices to prevent therapy and nursing-related denials and increase reimbursement under PDPM. I work to ensure compliance with Medicare and MAC rules/regulations by interpreting final rules, creating and presenting education, and notifying customers and staff members of any Congressional activity, updates, and advocacy related to Medicare. I also oversee the appeals for any of our customers’ denied Part A/B SNF and outpatient therapy denials by creating and submitting Redetermination and Reconsideration appeal letters and completing ALJ hearings. I oversee the tracking and managing of our company and customers\' denial statuses and liability amounts each month by creating extensive reports to determine success rates for closed and outstanding claims. I am RAC-CT certified and certified in Risk Adjustment Coding.