JANET BECKER

Reviewed IRF medical records for billing, coding, and regulatory compliance, resolving approximately 100 cases per week and tracking RAC, CERT, TPE, SMRC, and OIG reviews. Created and trained IRF Program Directors on Level 1/2 Medicare appeals and participated in ALJ hearings across 80+ IRFs.

Managed 200+ IRF RAC denials for HCA IRFs, reworked internal processes to improve appeal efficiency, and trained IRFs on Medicare appeals to achieve denial overturns. Led cross-functional improvements to streamline appeals processing.

Organized Medicare appeals for 800+ IRFs, conducted 250+ ALJ hearings via phone/video and recovered over $6M for subscribers. Reviewed outpatient and LTCH records to identify documentation and coding risks and proposed mitigation strategies.

Provided clinical oversight for 100–150 SNFs nationwide, developed manuals and training, and conducted 200+ ALJ hearings; promoted in 2005 to Manager of Appeals & Director of Medical Review to lead appeals specialists. Managed interactions with FIs, MACs, QICs, and OMHA to resolve complex cases.

Delivered clinical training and operations support across 40 SNFs, conducted extensive chart audits and quality assurance, and addressed Medicare A/B denials to improve productivity and financial outcomes. Developed workshops on Medicare, MDS, PPS, billing, and coding.

Recruited and trained therapists for Home Health and SNFs across PA, NJ, and DE, delivered clinical training on documentation and coding, and collaborated with administrators to ensure compliance and resolve Medicare denials. Supported marketing and operational initiatives.

Oversaw operations and clinical programs across 50 SNFs, supervised six regional managers, and led clinical training, compliance workshops, and financial management for rehab programs. Designed and implemented program-level operational improvements.

Administered Functional Capacity Evaluations for injured workers over a three-year engagement and testified at work-related hearings to support case outcomes. Provided detailed assessment reports and expert testimony.

Expanded the Occupational Therapy department from one to six staff and tripled department profits in 18 months while managing clinical, operational, and financial responsibilities. Implemented staffing and productivity improvements.

Led clinical and operational functions of a county SNF, managed eight therapists, served as CQI coordinator and clinical instructor, and oversaw financial planning and staff development. Supervised Level II OTR student fieldwork.

Supervised and trained COTAs across 15 SNFs, completed Medicare appeals and conducted ALJ hearings, and reviewed Medicare records for compliance and appropriate service utilization. Led education initiatives for interdisciplinary teams.

Provided direct rehabilitation services to Vietnam veterans in the amputee clinic and physical disabilities unit, collaborated with orthopedic surgeons, and trained with onsite prosthetists on prosthesis design and fabrication. Supported surgical and post-operative care.

Earned a Master of Management in Health Care Administration from Penn State Great Valley in 1996.

Completed a Certificate in Occupational Therapy at the University of Pennsylvania in 1970.

Completed a Bachelor of Arts in Biology with pre-medicine studies at Beaver College in 1968.

Grade: Summa Cum Laude

Graduated summa cum laude from Philadelphia High School for Girls with a college preparatory curriculum.

Attended courses at Bucks County Community College using GI Bill benefits.