Care Coordination Specialist

5 days ago


Carrollton, Texas, United States Cantex Continuing Care Network Full time
Job Summary

Cantex Continuing Care Network is seeking a highly skilled PCC/MDS Coordinator to join our team. As a Care Coordination Specialist, you will play a vital role in ensuring the proper reimbursement of Medicare and/or Medicaid patients through the Patient Assessment Instrument (RAI) process.

Key Responsibilities:

  • Maintain compliance with State and Federal regulations and published interpretations regarding Medicaid and/or Medicare rules.
  • Participate in pre-admission paperwork review to ensure patients meet qualifying medical necessity determination.
  • Attend standup meetings every weekday morning and coordinate the Weekly Reimbursement Meeting with Interdisciplinary Team Members.
  • Audit Clinical Records to ensure accurate documentation for care delivery and educate staff on documentation guidelines.
  • Obtain Medicare qualifying diagnoses and update physician certifications for each Medicare Part A patient.
  • Complete Minimum Data Set (MDS) assessments within the allotted timeframe for each Medicare and/or Medicaid patient.
  • Review 24-hour Nursing reports to capture possible changes in patient condition and prepare for Medicaid audits.
  • Track patient benefit days, validate daily census, and coordinate information with Financial Manager to ensure accurate billing.
  • Achieve at least budgeted rate expectations.
  • Supports and upholds Patient Care Management Systems as well as Financial Management Systems.

About Us

Cantex Continuing Care Network offers a dynamic work environment with opportunities for growth and development. Our commitment to quality patient care and excellent customer service sets us apart from other healthcare providers.

Requirements

  • A current, valid Texas nursing license is required (RN, LVN)
  • At least 2 years of LTC experience preferred
  • Must have an Acknowledgement of Completion Certificate through the HHSC RUG Online Training for Nursing Facilities
  • Must complete the American Association of Nurse Assessment Coordinators (AANAC) RAI Certification within 1 year of employment
  • Ability to effectively communicate, direct, and delegate tasks
  • Ability to read, write, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations

We Offer

  • An estimated salary of $65,000 - $80,000 per year, depending on experience
  • A competitive benefits package including medical, dental, and supplemental insurance plans
  • A highly competitive compensation package


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