Loriann Brock
Clinical Appeals Specialist-Occupational Therapist at UofL Health- Claim this Profile
Click to upgrade to our gold package
for the full feature experience.
Topline Score
Bio
Credentials
-
National Board of Certification in OT
National Board for Certification in Occupational Therapy (NBCOT)Nov, 2000- Nov, 2024 -
Certified Social Worker
Kentucky Board of Social WorkJan, 2015- Nov, 2024 -
Occupational Therapy
Kentucky Board of Occupational TherapyNov, 2000- Nov, 2024 -
RAC-CT
AANACJun, 2019- Nov, 2024
Experience
-
UofL Health
-
United States
-
Hospitals and Health Care
-
700 & Above Employee
-
Clinical Appeals Specialist-Occupational Therapist
-
Feb 2021 - Present
Clinical appeals management of denials across UofL health hospital campuses (inpatient rehab, acute care, mental health and alcohol drug services). Denial prevention strategy development, obtaining retro authorizations for services and assisting technical denials team in claim resolution. Skilled in DRG payment system, IRF PPS, and OP therapy billing. Assessing for coding and diagnosis errors resulting in claim denials. Utilizing clinical coverage policies across payers to support medical necessity of services provided for acute care, inpatient rehab, infusions and drug coverage.
-
-
-
RehabCare
-
United States
-
Hospitals and Health Care
-
700 & Above Employee
-
Appeal Specialist OTR/L
-
May 2014 - Dec 2020
Responsible for appealing denied rehabilitation service (physical, occupational, and speech therapy) claims and advocating for coverage for persons in need of skilled rehabilitation. Completes documentation review and research for appeals to redetermination and reconsideration levels of appeal through Center's for Medicare Services contracting MAC/QIC's. Finally, Administrative Law Judge hearings for cases reaching this level of appeal. Conducts evidence based research searches to support medical necessity based upon the Medicare Benefit Policy Manual. Supplies support for customer client chains and facility rehabilitation staff to meet appeal needs and assist with understanding Medicare requirements for documentation for payment.
-
-
-
Genesis
-
United States
-
Hospitals and Health Care
-
700 & Above Employee
-
Occupational Therapist
-
Jan 2013 - Sep 2016
Occupational therapist within skilled nursing facilities for both rehab to home and long term care residents focusing on screening, evaluation, treatment planning and therapeutic treatment interventions. Services provided include self care retraining, home managing skills, strengthening, balance and safety skills, fall risk reduction, contracture management, splinting, wheelchair seating and positioning and physical agent modalities of E-Stim and Ultrasound for pain and neuromuscular re-education.
-
-
-
-
ADC Social Work Intern
-
May 2013 - Apr 2014
Social work intern in the co-occurring adult intensive outpatient and partial hospitalization program. Social work intern in the co-occurring adult intensive outpatient and partial hospitalization program.
-
-
-
-
Social Work Intern-ADC
-
Aug 2012 - May 2013
Alcohol and drug counseling Social Work graduate intern. Focused on screening, assessment, treatment planning and group and individual treatment. Group facilitator for chemical dependency court mandated clients and women's battery intervention clients. Group work within the KY Dept. of Corrections re-entry Substance Abuse Programming for individuals on parole and probation. Individual counseling for individuals with substance abuse or anger issues. Alcohol and drug counseling Social Work graduate intern. Focused on screening, assessment, treatment planning and group and individual treatment. Group facilitator for chemical dependency court mandated clients and women's battery intervention clients. Group work within the KY Dept. of Corrections re-entry Substance Abuse Programming for individuals on parole and probation. Individual counseling for individuals with substance abuse or anger issues.
-
-
-
SunDance Rehabilitation
-
Hospitals and Health Care
-
1 - 100 Employee
-
Occupational Therapist
-
Dec 2000 - Jan 2013
Company purchased by Genesis January 2013. Occupational therapist within skilled nursing facilities for both rehab to home and long term care residents focusing on screening, evaluation, treatment planning and therapeutic treatment interventions. Services provided include self care retraining, home managing skills, strengthening, balance and safety skills, fall risk reduction, contracture management, splinting, wheelchair seating and positioning and physical agent modalities of E-Stim and Ultrasound for pain and neuromuscular re-education.
-
-
-
-
Occupational Therapy Intern
-
1999 - 2000
OT intern on the geri-psych unit as well as rotational intern for the adult inpatient mental health and co-occurring chemical dependency outpatient programs. OT intern on the geri-psych unit as well as rotational intern for the adult inpatient mental health and co-occurring chemical dependency outpatient programs.
-
-
-
-
Occupational Therapy Intern
-
1999 - 1999
OT intern within hospital acute and IC units. Primary focus adults and seniors. Rotational duties with hand therapy clinic. OT intern within hospital acute and IC units. Primary focus adults and seniors. Rotational duties with hand therapy clinic.
-
-
-
-
Physician Answering Service Operator
-
1994 - 1999
Telephone Paging service for physicians and after hours emergency medical operator. Telephone Paging service for physicians and after hours emergency medical operator.
-
-
Education
-
2012 - 2014
University of Louisville
Master's degree, Social Work -
1995 - 2000
Eastern Kentucky University
Bachelor's degree, Occupational Therapy/Therapist
Community
