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Clinical Reimbursement Specialist

3 months ago

Pacific Beach, United States Vi Living Full time
Overview:

Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.

What We Offer:

  • Competitive pay
  • Exceptional benefits
  • Generous Paid Time Off - start accruing on day one
  • 401k with company match
  • Paid maternity and paternity benefits
  • Award-winning training and development
  • Tuition Reimbursement
  • Luxury work environment
  • Meaningful and rewarding work

Vi at La Jolla Village is located at 8515 Costa Verde Blvd, San Diego CA 92122

Responsibilities:

Clinical Reimbursement Specialist (CRS) – RN or LVN

Collaborates with the DON, CRM (where applicable) and various disciplines to assist in the completion of the Minimum Data Set (MDS), Resident Assessment Instrument (RAI), and all associated processes. With guidance and oversight from the DON or CRM (where applicable), the CRS ensures completion of the assessment within the timeframe as mandated by federal regulations and company policies. The CRS manages the overall resident assessment process and tracking of all Medicare/Managed Care/Medicaid case mix documents in order to ensure appropriate and optimal reimbursement for services provided within the Care Center. Responsibilities also include assisting with the coordination of resident care planning processes under the direction of the DON or CRM (where applicable). Performs other duties as assigned.

Qualifications: Education and Experience:
  • Education: Graduation from a School for Registered Nursing or Licensed Vocational Nurse is required.
  • Work Experience: Minimum 1 year of previous experience in an MDS/Clinical Reimbursement Nurse role is preferred.
  • Licensure / Certification, where required:
    • Current State Licensure as a Registered Nurse or Licensed Vocational Nurse in the state where practicing is required. Current CPR and Automated External Defibrillator (AED) certifications are required.
    • Current First Aid certification is required or must be willing and able to become First Aid certified. Food handlers certification, where required.
Key Competencies:
  • Maintains a courteous and professional manner through interactions with others.
  • Uses a resident and customer-focused approach to problem solving and goal setting.
  • Uses discretion in handling confidential information, incorporating all Federal, State and local privacy and confidentiality requirements.
  • Excellent knowledge of case-Mix, and the Federal Medicare PPS process as required.
  • Thorough understanding of the Quality Indicator Process, and OBRA regulations.
  • Must possess knowledge of regulatory compliance and Continuing Care Retirement Community operations.
  • Good oral and written communication skills and ability to interface and maintain effective relationships with all departments and employees in a team-oriented environment.
  • Computer proficiency using Microsoft Office.
  • Must be sensitive to the needs of older adults and enjoy working with a senior population.

The application window is anticipated to close within 30 days of the date of the posting.

Pay Range: USD $38.00 - USD $52.63 /Hr.