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Healthcare Reimbursement Coordinator

2 months ago

Dallas, Texas, United States Creative Solutions in Healthcare Full time
Job Overview

Position: MDS Regional Reimbursement Nurse

Role Summary:

Are you dedicated to enhancing MDS Clinical Reimbursement standards in the long-term care sector? If you are enthusiastic about providing essential support to MDS Case Managers regarding MDSs, Quality Measures, and Medicare and Medicaid reimbursement, this role is tailored for you.

As a key player in our organization, you will oversee a network of 5-8 Skilled Nursing Facilities (SNFs) within your designated area.

Key Responsibilities:

  • Offer guidance and serve as a resource for both regional and facility personnel concerning the RAI MDS process, as well as Medicare and Medicaid reimbursement protocols.
  • Deliver comprehensive training on systems related to RAI MDS, clinical software, and reimbursement frameworks.
  • Instruct new MDS Case Managers on conducting MDS assessments, formulating care plans, evaluating resident responses, maintaining clinical documentation, and adhering to all relevant deadlines.
  • Support facilities in achieving Quality Measures, QIPP QMs, and CMS 5-Star Ratings.
  • Regularly monitor and assess facility performance in Medicare and Medicaid management.
  • Facilitate accurate claims processing and billing by participating in reimbursement-related meetings and ensuring effective operational processes.

Qualifications:

  • Current nursing license in good standing.
  • Experience in MDS and long-term care.
  • Proficient understanding of MDS, Clinical Reimbursement, and Quality Measures.
  • Exceptional professionalism and organizational abilities.
  • Adaptability in work schedule and capability to work autonomously.
  • Willingness to travel as required.

Benefits:

  • Comprehensive Health, Dental, and Vision Insurance.
  • Additional policies including Accidental Death & Dismemberment, Short-Term Disability, and Critical Illness coverage.
  • Life Insurance options including Whole and Term policies.
  • Tuition Reimbursement opportunities.
  • Generous Paid Time Off.
  • Immediate access to 401(k) plans.
  • Outstanding corporate support.