PCC/MDS Coordinator
5 days ago
The PCC/MDS Coordinator plays a vital role in ensuring accurate reimbursement for Medicare and Medicaid patients. This position is responsible for managing quality patient care, adhering to federal and state standards, and collaborating with the Interdisciplinary Team to achieve optimal care delivery.
Key Responsibilities:
• Maintains compliance with Medicaid and Medicare regulations, ensuring accurate reimbursement for patients.
• Participates in the assessment of pre-admission paperwork to ensure patients meet qualifying medical necessity determination.
• Coordinates the Weekly Reimbursement Meeting with the Interdisciplinary Team to ensure proper Medicare and Medicaid reimbursement to match care delivery.
• Audits the Clinical Record to ensure appropriate documentation for actual care delivery, educating and training staff on documentation guidelines.
• Obtains Medicare qualifying diagnosis(es) on Medicare Part A patients and updates diagnosis for each change in diagnosis.
• Initiates and updates physician certifications for each Medicare Part A patient.
• Completes all Minimum Data Set (MDS) assessments within the allotted time frame for each Medicare and Medicaid patient.
Requirements:
A current, valid Texas nursing license is required (RN, LVN). At least 2 years of LTC experience is 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 at times, delegate tasks. Ability to read, write, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, nursing/Patient progress notes, and nursing procedures. Ability to effectively present information and respond to questions from department heads, customers, (patients, family members, physicians, etc.) and the public.
Cantex Continuing Care Network:
Cantex is committed to a culture that respects our differences and values the contributions of all people. We are an Equal opportunity employer; we offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.
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