Clinical Reimbursement Specialist
2 weeks ago
We are seeking a highly skilled Clinical Reimbursement Specialist to join our team at Genesis HealthCare Services. As a key member of our clinical team, you will be responsible for managing the overall process and tracking of all Medicare/Medicaid case-mix documents to ensure accurate reimbursement for all services provided within the nursing center.
Key Responsibilities:
- Maintain accurate schedules of all MDS assessments, including proper reference dates throughout the patient stay.
- Ensure timely submission of MDS assessments, including case-mix, OBRA, and OSRA required assessments.
- Perform concurrent MDS review to ensure appropriate RUGs category is achieved through 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 case-mix education and instruction on MDS terminology and format.
Benefits:
- Health, Dental, Vision, Company-paid life insurance, 401K, Paid Time Off
- Variable compensation plans
- Inclusive workplace with DEI committee
- Nursing Student Loan Debt Repayment and Tuition Assistance
- Tuition, Travel, and Wireless Service Discounts
- Employee Assistance Program to support mental health
Requirements:
- Graduate of an accredited School of Nursing with current RN licensure in the state in which employment occurs
- 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 (excluding ALFs/ILFs)
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Media, Pennsylvania, United States Genesis HealthCare Full timeAbout the RoleWe 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 ResponsibilitiesMaintain accurate schedules of all MDS assessments, including reference dates, and...
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