Clinical Reimbursement Specialist

2 days ago


San Diego, California, United States Vi Living Full time
Job Title: Clinical Reimbursement Specialist

At Vi Living, we are seeking a highly skilled Clinical Reimbursement Specialist to join our team. As a Clinical Reimbursement Specialist, you will play a critical role in ensuring accurate and timely reimbursement for services provided to our residents.

Responsibilities:
  • Collaborate with the DON, CRM, and other disciplines to complete the Minimum Data Set (MDS), Resident Assessment Instrument (RAI), and associated processes.
  • Manage the overall resident assessment process and tracking of Medicare/Managed Care/Medicaid case mix documents to ensure optimal reimbursement.
  • Assist with resident care planning processes under the direction of the DON or CRM.
Qualifications:
  • Graduation from a School for Registered Nursing or Licensed Vocational Nurse is required.
  • Minimum 1 year of previous experience in an MDS/Clinical Reimbursement Nurse role is preferred.
  • Current State Licensure as a Registered Nurse or Licensed Vocational Nurse in the state where practicing is required.
Key Competencies:
  • Maintains a courteous and professional manner through interactions with others.
  • Uses a resident and customer-focused approach to problem solving and goal setting.
  • Excellent knowledge of case-Mix, and the Federal Medicare PPS process.


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