Senior Clinical Reimbursement Specialist

6 days ago


Great Barrington, Massachusetts, United States Fairview Commons Full time

At Fairview Commons, we are seeking a highly skilled and experienced Senior Clinical Reimbursement Specialist to join our team. This key role plays a vital part in managing all aspects of the Minimum Data Set (MDS) process, ensuring clinical integrity and accurate reimbursement for services provided.

About the Role

The successful candidate will be responsible for:

  • Managing all aspects of the MDS process, including clinical and financial audits, educational opportunities, and strategic planning related to ARDs.
  • Ensuring Interdisciplinary Team (IDT) compliance with state/federal requirements and timeframes related to MDS, billing, and care planning.
  • Interpreting revenue-related data, identifying revenue-related risks, and assisting with action plans as needed.
Key Responsibilities

The ideal candidate will have:

  1. Experience in performing independent and/or affiliate level clinical and financial audits.
  2. Strong analytical and problem-solving skills, with the ability to work independently and collaboratively as part of a team.
  3. A Bachelor's degree in a healthcare-related field or equivalent experience.
  4. Minimum 5 years of experience in clinical reimbursement, including MDS and care planning.
  5. Excellent knowledge of state and federal regulations related to MDS, billing, and care planning.
What We Offer

We provide:

  • A competitive salary range of $80,000 - $100,000 per year.
  • Generous time off and exceptional health insurance.
  • Ongoing education and career growth opportunities.


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