Clinical Reimbursement Specialist

1 week ago


Media, Pennsylvania, United States Genesis HealthCare Full time
About the Role

We are seeking a highly skilled Clinical Reimbursement Specialist to join our team at Genesis HealthCare. As a Clinical Reimbursement Specialist, you will play a critical role in ensuring accurate and timely reimbursement for our services.

Key Responsibilities
  • Maintain accurate schedules of all MDS assessments, including reference dates, and ensure timely submission of MDS assessments.
  • Perform concurrent MDS reviews to ensure appropriate RUGs categories are achieved through the capture of clinical information and identify opportunities to enhance reimbursement.
  • Communicate case-mix data required for billing to the Business Office, including RUGs categories, modifiers, state case-mix scores, etc.
  • Serve as the nursing center resource for MDS/RUGs and state case-mix systems, providing staff education and instruction on MDS terminology and format.
Requirements
  • Graduate of an accredited School of Nursing with current RN licensure in the state of employment.
  • One year of long-term care clinical nursing experience.
  • Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization, and/or case management is highly desirable.
  • Maintain current BLS/CPR certification.
What We Offer
  • Competitive hourly rate of $40.00 - $45.00.
  • Full-time position with a comprehensive benefits package, including health, dental, vision, and 401K.
  • Opportunities for career growth and development.
  • A supportive and inclusive work environment.


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