Medical Reimbursement Specialist

3 weeks ago


Johnson City, New York, United States Susquehanna Nursing and Rehabilitation Full time

**Job Summary**

Susquehanna Nursing and Rehabilitation seeks a highly skilled Medical Reimbursement Specialist to join our team. This role is responsible for coordinating Medicare, Managed Care, and Medicaid activities at the facility.

The successful candidate will have excellent time management and organization skills, as well as experience in reimbursement, PDPM, and quality measures associated with the MDS assessment.

Key Responsibilities:

  • Provides education and assistance to facilities on Medicare/Medicaid related areas.
  • Interacts with Medicare, Managed Care, and Medicaid claims review units to ensure compliance with company procedures and federal, state, and local regulations.
  • Completes compliance with Medicare, Managed Care, Medicaid, and third-party payers and company procedures.
  • Establishes systems and programs designed to correct any non-compliance situation.
  • Monitors and identifies utilization issues and establishes systems to maximize utilization and reimbursement.

Required Skills and Qualifications:

  • Demonstrates experience in reimbursement, PDPM, and quality measures as associated with the MDS assessment.
  • Excellent communication, interpersonal, and problem-solving skills.
  • Ability to effectively manage multiple priorities and meet deadlines.
  • In-depth knowledge of regulatory requirements and standards of care in long-term care settings.

Compensation:** $29-$32 per hour, dependent upon experience.



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