Clinical Reimbursement Specialist
4 weeks ago
Are you are you a Registered Nurse (RN) who is passionate about MDS? When you join Ciena Health Care Company as a Clinical Resource Specialist, you will share your expertise with the MDS nurses in several facilities. In this role, you will audit and evaluate Medicare compliance and the RAI process in four facilities in Virginia and one facility in North Carolina. If you love teaching and communicating with other nurses, this is a great role for you
The successful applicant have a comprehensive knowledge of Medicare, PDPM, RAI process, quality measures, as well as OBRA regulations and live in Virginia.
Join us with an attractive benefits offering:
- Competitive pay
- Medical, dental, and vision insurance
- 401K with matching funds
- Life Insurance
- Employee discounts
- Student Loan Forgiveness
- Career Advancement Education Assistance
Responsibilities:
- Ensure the RAI process is complete and assessments are complete.
- Audit Completion of MDS, CAA’s and care plans within regulated time frames.
- Provide teaching as needed for MDS nurses in assessing resident through physical assessment, interview and chart review.
- Assist MDS nurses in follow up on resident care needs with care givers, including physician, nursing, social services, therapy, dietary, and activity staff.
- Reviews MDS nurse completion of information from hospitals, consults, and outside agencies and uses such information to complete the assessment and care planning.
Requirements:
- Registered Nurse RN in the state.
- Knowledge of the Resident Assessment Instrument (RAI) process, including the principles the Patient Driven Payment Model is required.
- Knowledge of regulatory standards and compliance requirements.
- 100% travel with some overnight stays possible.
Ciena Healthcare
We are a provider of skilled nursing, subacute, rehabilitative, and assisted living services dedicated to achieving the highest standards of care in five states including Michigan, Ohio, Virginia, North Carolina, and Indiana. We serve our residents with compassion, concern, and excellence, believing that every one of them is a unique person who deserves our best each day that we care for them. If you have a passion for improving the lives of those around you and working with others who feel the same way.
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