Clinical Reimbursement Specialist

4 weeks ago


Trenton, New Jersey, United States Springpoint Living Full time
Job Summary

Springpoint Living is seeking an experienced Clinical Reimbursement Specialist to join our team. The ideal candidate will have a strong background in regulatory compliance and quality improvement efforts to attain appropriate Medicare or Managed Care reimbursement.

Key Responsibilities
  • Ensure compliance with Federal and State regulations and company policies that govern Medicare and state payment systems.
  • Review accuracy of ICD-10 Coding and provide oversight of the RAI process and policies.
  • Audit MDS for accuracy and timeliness, and coordinate and provide education to the MDS Coordinators and Interdisciplinary team related to the RAI process, regulatory changes and reimbursement.
  • Audit accuracy of PBJ data prior to submission, and provide temporary MDS completion support at the communities.
  • Assure care planning and care conferencing is taking place according to the state and regulatory guidelines.
  • Provide in-service training and orientation to facility staff regarding the MDS, ADL's and accuracy at the communities.
  • Conducts concurrent MDS reviews to assure the achievement of maximum allowable PDPM categories allowed by law.
Requirements
  • Graduate of an approved Registered Nurse Program required.
  • Multistate Registered Nurse licensure required.
  • RNAC Certification required.
  • Prior experience in Medicare reimbursement and/or MDS experience required.
Benefits
  • Comprehensive Benefits Package Including Medical/Dental/Vision/RX Plans, 401(k) with Company Match, PTO and Holidays, Flexible Spending Accounts, Supplemental Life Insurance, Employee Bonus Referral Program, Employee Assistance Program, Wellness Program, and Tuition Reimbursement.
Salary

$125,000.00 / yr



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