MDS Coordinator

Wedgemere HealthCare is seeking a highly skilled MDS Coordinator to join our team. As a key member of our healthcare operations team, you will be responsible for ensuring the accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, and other payer program requirements.

• Ensure timely, accurate, and complete assessment of the resident's health and functional status during the entire assessment period.
• Ensure accurate and timely completion of all Medicare/Medicaid case-mix documents in order to assure appropriate reimbursement for services provided within the facility.
• Work in collaboration with the facility Director of Rehab to ensure the most appropriate assessment reference date (ARD) is utilized for Medicare/Managed Care Assessments.
• Track Skilled (MRA/HMA/HMO) customers utilizing Case Management Tools to determine continued and appropriate Medicare/Managed Care eligibility and benefit period through regular communications with Clinical Reimbursement Specialist, Business Office, and external Case Managers.
• Ensure that additional requirements of the Medicare Program are met, such as Physician certification and re-certification.
• Perform concurrent MDS review to assure appropriate RUG/PDPM category is achieved through the capture of appropriate clinical information.
• Participate in the interdisciplinary team process to communicate opportunities, facilitate efficient and effective care plan development and management.
• Ensure the accurate and timely completion of all MDS assessments including PPS, scheduled and unscheduled, Admission, quarterly, annual, and significant change.
• Collaborate with the interdisciplinary team to identify significant change in status and implementation of Significant Change in Status MDS.
• Maintain an accurate schedule of all MDS assessments to include the proper reference dates throughout the residents stay.
• Track, record, and analyze all default days and rectify if appropriate. Implement corrective action to prevent further default action.
• Perform Modifications/Inactivation's of assessments in accordance with CMS Correction Policy and collaboration with Clinical Reimbursement Specialist.
• Conduct regular audit of MDS process including validation of coding documentation.
• Ensure the timely electronic submission of all Minimum Data Sets and secure back-up personnel to complete this process.
• Review the validation reports and ensure that appropriate follow-up action is taken.
• Review Late/Missed assessment reports monthly and address issues as appropriate.
• Communicate with the Business Office and Administrator on a regular basis regarding RUG/PDPM distribution, default days/unassigned days, case mix index (if applicable).
• Review discharged managed care with BOM on a weekly basis.
• Participate in month-end Triple Check and other meetings per Next Step Healthcare's policy.
• Facilitate Case Management meeting per Next Step Healthcare's policy.
• Function as an RAI and Clinical Reimbursement resource to the facility staff.
• Utilize Relias annual competency training as well as for educational resource as needed.
• Assist in the orientation and training of new associates on the RAI process and ensure the dissemination of any new or updated materials regarding the RAI and/or Federal and State regulations.
• Ensure timely RN coordinator

• Must be a graduate of an accredited school of nursing with current RN or LPN licensure in the state in which employment occurs.
• Minimum of two years health care experience.
• Experience with MDS completion, reimbursement, clinical resource utilization, and/or case management is highly desirable.
• Ability to work flexible work hours to support business requirements.
• Complete and pass all Next Step Healthcare specific MDS/RUGs training modules (Relias) within the first 90 days of employment and ongoing per company policy.
• Competency with standard office software applications as well as software applications related to MDS/RAI processes.
• High initiative and ability to efficiently and effectively lead interdisciplinary teams and coordinate and manage RAI process.
• Ability to utilize both local and corporate resources in the execution of job responsibilities.

• Customer Service Oriented
• Ability to be patient while interacting with challenged or difficult residents
• Demonstrates organizational and critical thinking skills
• Strong interpersonal skills
• Ability to work independently, problem solve, and make decisions as necessary
• Ability to create a resident-centered environment
• Knowledge of policies and procedures and state and federal regulations

This job requires the following physical activities:

• Stand: Occasionally up to 1/3
• Walk: Occasionally up to 1/3
• Sit: Occasionally up to 1/3
• Talk or hear: Frequently 1/3 to 2/3
• Finger, handle, or feet: Frequently 1/3 to 2/3
• Push/pull: Occasionally up to 1/3
• Stop, kneel, crouch, or crawl: Occasionally up to 1/3
• Reach with hands and arms: Frequently 1/3 to 2/3
• Taste or smell: None

This job requires the following lifting and carrying activities:

• Up to 10 lbs: Frequently 1/3 to 2/3
• Up to 20 lbs: Frequently 1/3 to 2/3
• Up to 50 lbs: Occasionally up to 1/3
• Up to 100 lbs: Occasionally up to 1/3
• > 100 lbs: None

This job has special vision requirements:

• Close Vision (clear vision at 20 inches or less): None
• Distance Vision (clear vision at 20 feet or more): None
• Color Vision (ability to identify and distinguish colors): None
• Peripheral Vision (ability to observe an area that can be seen up and down or to the left and right while eyes are fixed on a given point): None
• Depth Perception (three-dimensional vision; ability to judge distances and spatial relationships): None
• Ability to Adjust Focus (ability to adjust eye to bring an object into sharp focus): None

This job has special hearing requirements:

• Ability to hear alarms on equipment: None
• Ability to hear client call: None
• Ability to hear instructions from physician/department staff: None