Medicare and Medicaid Coordinator

3 days ago


Jersey City, New Jersey, United States Hudson Elms Nursing Home Full time
Job Title: MDS Nurse

Hudson Elms Nursing Home is seeking a highly skilled MDS Nurse to join our team. As a key member of our staff, you will be responsible for coordinating and monitoring Medicare, Managed Care, and Medicaid revenue at our facility.

Key Responsibilities:
  • Coordinate and monitor Medicare, Managed Care, and Medicaid revenue at the facility.
  • Ensure residents receive optimal skilled services to meet their needs for independent function and potential discharge to the community.
  • Monitor facility Quality Measures, identify issues, and assist with corrective actions.
  • Provide education and assistance to facilities on Medicare/Medicaid-related areas.
  • Interact with Medicare, Managed Care, and Medicaid claims review units and compliance units.
  • Coordinate weekly Insurance/Medicare Meetings to evaluate resident progress and ongoing skilled services needs.
  • Complete and assess compliance with Medicare, Managed Care, and Medicaid procedures.
  • Establish systems and programs to correct non-compliance situations.
  • Monitor and identify utilization issues and establish systems to maximize utilization and reimbursement.
  • Provide ongoing orientation and training to facility staff on Medicare, Managed Care, and Medicaid procedures.
Requirements:
  • Two years of experience in Medicare/Medicaid areas in long-term care or clinical training.
  • Excellent communication and teaching skills in individual and group settings.
  • Ability to maintain regular attendance and travel as required.
  • Working knowledge of MDS 3.0, care plans, care guides, and the CMI reimbursement process.
What We Offer:

Hudson Elms Nursing Home offers a competitive salary and benefits package, as well as opportunities for professional growth and development.



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