Clinical Reimbursement Specialist

3 weeks ago


Pennsylvania USA, United States Wallingford Nursing & Rehab - Wallingford, PA Full time
Job Summary

We are seeking a skilled Clinical Reimbursement Specialist to join our team at Wallingford Nursing & Rehab in Wallingford, PA. As a key member of our healthcare team, you will play a critical role in ensuring accurate and timely reimbursement for our services.

Key Responsibilities:
  • Maintain accurate schedules of MDS assessments, including reference dates, to ensure timely submission of case-mix documents.
  • Perform concurrent MDS reviews to identify opportunities for enhanced reimbursement and ensure accurate RUGs categorization.
  • Communicate case-mix data required for billing to the Business Office, including RUGs categories, modifiers, and state case-mix scores.
  • Provide education and instruction on MDS terminology and format to nursing staff, serving as a resource for MDS/RUGs and state case-mix systems.
Requirements:
  • Graduate of an accredited School of Nursing with current RN licensure in the state of employment.
  • One year of long-term care clinical nursing experience, with experience in Medicare/Medicaid reimbursement, MDS completion, and clinical resource utilization highly desirable.
  • Current BLS/CPR certification required.
Benefits:
  • Competitive hourly rate of $45.00.
  • Comprehensive benefits package, including health, dental, vision, and company-paid life insurance.
  • 401K and paid time off.
  • Variable compensation plans and inclusive workplace with DEI committee.
  • Nursing Student Loan Debt Repayment and Tuition Assistance.
  • Tuition, travel, and wireless service discounts.
  • Employee Assistance Program for mental health support.


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