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MDS Reimbursement Specialist
2 months ago
Position Overview:
The MDS Reimbursement Specialist at Rochester Manor plays a crucial role in overseeing the management and tracking of Medicare and Medicaid case-mix documentation, ensuring optimal reimbursement for services rendered within the nursing facility.
Key Responsibilities:
- Maintain a precise schedule for all MDS assessments, ensuring accurate reference dates throughout the patient’s stay.
- Guarantee timely submission of MDS assessments, including case-mix, OBRA, and OSRA required evaluations.
- Conduct concurrent MDS reviews to ensure the appropriate RUGs category is achieved by capturing relevant clinical information, while identifying opportunities to enhance reimbursement.
- Communicate essential case-mix data for billing purposes to the Business Office, including RUGs categories, modifiers, and state case-mix scores.
- Serve as a resource for MDS/RUGs and state case-mix systems, providing education and guidance to staff on MDS terminology and formats.
Benefits:
- Comprehensive health, dental, and vision insurance.
- Company-paid life insurance and 401K plan.
- Paid Time Off and variable compensation plans.
- Inclusive workplace with a dedicated DEI committee.
- Support for nursing student loan debt repayment and tuition assistance.
- Discounts on tuition, travel, and wireless services.
- Employee Assistance Program for mental health support.
- Financial assistance through the Employee Foundation for unforeseen hardships.
Qualifications:
- Graduate of an accredited School of Nursing with a current RN license in the applicable state.
- Minimum of one year of clinical nursing experience in long-term care.
- Familiarity with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization, and/or case management is highly desirable.
- Current BLS/CPR certification is required.
