Clinical Reimbursement Specialist

2 weeks ago

Florida, United States QRM Full time $60,000 - $100,000 per year

QRM has an exciting opportunity for a Clinical Reimbursement Specialist We provide rehab management services nationwide and we have an opportunity for the right person to join this growing organization in a Corporate role, covering multiple SNF locations. MUST be a licensed RN with compact licensure, RAC-CT preferred. Ideal candidates will reside Florida or North Carolina. Occasional overnight travel may be required.

Summary:

This is a full-time role comprised of Clinical Reimbursement oversight responsibilities for multiple skilled nursing facilities. Please review responsibilities and qualifications carefully before applying.

Responsibilities:

  • Provide support to MDS coordinators and interdisciplinary teams including education, process implementation, and ongoing support/management of systems
  • Provide ongoing education and guidance to MDS teams to improve coding accuracy, workflow organization, and compliance
  • Collaborate with facility staff to identify barriers to success impacting quality measures, Five Star rating, reimbursement capture
  • Guide the IDT in implementing best practices relating to the RAI process
  • Analyze and report on key performance indicators to measure success and proactively identify areas of need
  • Maintain and share expertise/knowledge related to reimbursement and quality outcomes
  • Work in conjunction with teams to resolve issues, endorse changes and conduct follow-ups to establish that recommendations are effectively implemented and monitored for appropriateness
  • Promote compliance by performing periodic audits of assessments, supporting documentation, and other relevant data

Qualifications:

  • Current licensure in the state of employment- Compact licensure preferred
  • Florida location ideal
  • Prefer RN with multi-site experience
  • Experience in high-volume Skilled Nursing Facility with solid understanding (3+ years) of the MDS and RAI Process
  • Experience with multiple payment models (PDPM, LTC Case-Mix reimbursement)
  • Microsoft Office proficiency required, with the aptitude to learn new programs as needed, being computer savvy is necessary
  • Highly motivated and detail oriented professional with excellent analytical and organizational skill set
  • Capable of working independently and as part of a team
  • Adept skillset for multi-tasking, sense of urgency, ability to prioritize
  • Ability to effectively communicate with a wide range of individuals, professional demeanor is imperative
  • Ability to travel to client sites as needed

Need professional, outgoing, organized personality ready to learn, motivate, teach and bring valued experience to the table day one We are a dynamic, growing company and seeking the right team member to occupy this exciting opportunity. Eligibility for benefits (medical/dental/vision/paid holidays/PTO) and competitive pay.

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