MDS Nurse RN with 2 years MDS experience

1 month ago

Medina, United States Medina Center for Rehabilitation Full time
JOB DESCRIPTION

MDS COORDINATOR

 

 

 

 

DEPARTMENT:                    Clinical Reimbursement

 

POSITION:                            CLINICAL REIMBURSEMENT SPECIALIST

 

SUPERVISOR:                      Administrator

 

POSITION SUMMARY:        Coordinates Medicare, Managed Care and Medicaid activities at the facility.  Educates Administrator and facility staff on innovative procedures to maximize utilization and reimbursement through the completion of the MDS, care plan and care guide process.

 

 

ESSENTIAL POSITION FUNCTIONS:

 

  • Education – Provides education and assistance to facilities on Medicare/Medicaid related areas including eligibility, certification, coverage, documentation, utilization and reimbursement.  Assists facilities with initial certification procedures and follow-up of problem areas.  Updates policies and procedures to reflect current changes. 

  • Coordination – Interacts with Medicare, Managed Care and Medicaid claims review unit and compliance unit to assist facilities in complying with company procedures and federal, state and local regulations.  Reports regularly to administration on issues and activities.  Interacts with the Medicare and managed Care intermediary in professional areas of coverage and documentation.  Assists in review and preparation of denied claims or administrative record reviews by outside intermediaries.

     

  • Monitoring –Completes and assess compliance with Medicare, Managed Care and   Medicaid and third party payers and company procedures.  Establishes systems and programs designed to correct any non-compliance situation. Participates with any outside reimbursement audits to acquire first hand knowledge of areas that might lead to system failures.

     

  • Administration – Establishes and maintains current statistical data associated with the Medicare, Managed Care and Medicaid programs by region.  Cooperates with operations to monitor activities for contractor programs, i.e. therapies, utilization review.  Reviews and maintains Medicare, Managed Care and Medicaid reference materials.

     

  • Financial Management – Monitors and identifies utilization issues.  Establishes systems and programs to maximize utilization and reimbursement.  Establishes system to identify rehabilitations training needs to provide training and recommendations to enhance therapy utilization.  Monitors compliance with third party policies and procedures for authorizations for payment and provision of services.

     

  • Training – Provides ongoing orientation and training to appropriate facility staff regarding the Medicare, Managed Care and Medicaid and other contracted third party payers. Programs.  Provides education regarding changes in any program.

     

  • Meetings – Coordinates, facilitates and attends meetings.

     

  • Committees – Attends and participates in committees as assigned.

     

  • Staff Development – Attends and participates in training and other learning activities at the facility level.

  • Gathers data and gives direction to acquire accurate and timely completion of MDS 3.0 as it relates to Medicare, Managed Care and Medicaid. Monitors, coordinates and enhances the completion of the MDS and the interdisciplinary team members in a professional manner.

  • Makes ones self available for Regional visits to acquire knowledge and discuss any on-going issues at the facility level as it relates to the accurate and timely completion of the MDS.

  • Is the chair person for the care plan meeting and conducts those meetings in a thorough manner capturing the accurate information revealed through the completion of the MDS.

  • Audits adl logs and assessments etc. to ensure that information is accurate and timely in completing the MDS assessment tool.

     

  • All other duties as assigned.

     

  • Communicates and observes the Corporate Compliance Program effectively and complies with Code of Conduct when performing work functions.

     

     

    SUMMARY OF QUALIFICATIONS:  Able to perform each of the essential position functions.

     

  • A Registered Nurse in the State of New York with a Bachelor’s Degree in nursing is preferred, but not limited to this requirement.

     

  • Prefer two year’s experience in Medicare/Medicaid areas in long-term care or clinical training.

     

  • Must have excellent communication and teaching skills in both individual and group settings.

     

  • Must be capable of maintaining regular attendance and be available to travel including overnight travel as required.

     

  • Must be capable of performing all of the essential job functions of this position, with or without reasonable accommodations.

     

  • Possess working knowledge of MDS 3.0, care plans, care guides and the CMI reimbursement process.

     

     

    This organization reserves the right to revise essential position functions and responsibilities as the need arises.

  • MDS Coordinator

    2 months ago

    Medina, United States life care center of America Full time

    Live the Mission Position Summary The RN MDS Coordinator coordinates and assists with completion and submission of accurate and timely interdisciplinary MDS Assessments, CAAs, and Care Plans according to CMS RAI Manual Regulations and in accordance with all applicable laws, regulations, and Life Care standards. Education, Experience, and...

  • MDS Nurse Coordinator

    5 months ago

    Medina, United States Medina Center for Rehabilitation Full time

    JOB DESCRIPTIONMDS COORDINATORDEPARTMENT:                    Clinical ReimbursementPOSITION:                            CLINICAL REIMBURSEMENT SPECIALISTSUPERVISOR:                      AdministratorPOSITION SUMMARY:        Coordinates Medicare, Managed Care and Medicaid activities at...

  • Registered Nurse

    2 weeks ago

    Medina, United States Medina Center for Rehabilitation Full time

    Medina Center for Rehabilitation - JOB DESCRIPTIONMDS COORDINATOR    DEPARTMENT:                    Clinical Reimbursement POSITION:                            CLINICAL REIMBURSEMENT SPECIALIST SUPERVISOR:                      Administrator POSITION SUMMARY:        Coordinates...

  • Physician (MD)

    1 week ago

    Medina, United States HarmonyCares Full time

    OverviewIn order to make an application, simply read through the following job description and make sure to attach relevant documents.HarmonyCares is one of the nation's largest home-based primary care practices. HarmonyCares is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes HarmonyCares,...

  • Occupational Therapist – Full-Time-HOME HEALTH

    4 months ago

    Medina, United States Blue Sky Full time

    Overview: Must be a licensed and or a registered therapist to be considered. ** EXCLUSIVE NEW JOB OPPORTUNITY!!** ***Highly competitive rates and benefits package! *** Do you know a therapist who's a perfect fit for our team? EARN UP TO $1,000 by referring a clinician to the Enhance family of brands! Make a difference and get rewarded for...

  • Schools - Speech Language Pathologist

    4 weeks ago

    Medina, United States ProCare Therapy Full time

    Job DescriptionJob DescriptionMinimum 1+ years speech therapy experience required.Hiring Speech Language Pathologists (SLP) in Medina, NYfor the 24/25 School Year At ProCare Therapy, we believe that every student deserves access to high-quality education, including support for their communication and language skills. As such, we are partnered with a school...

  • Seattle, WA Home Health Contract Position

    2 weeks ago

    Medina, United States Sunbelt Staffing Full time

    Job DescriptionJob DescriptionMinimum 1+ years nursing experience required.Job Title: Home Health Registered Nurse (RN)Location: Seattle, WAType: ContractDuration: 13 weeksShift: Monday-Friday, with potential on-callJob Description: Sunbelt Staffing is hiring a skilled Home Health Registered Nurse (RN) for a 13-week contract in Seattle, WA. This position...

  • Staff Nurse

    2 months ago

    Medina, United States Incredible Health Full time

    Hospitals on Incredible Health are actively hiring and accepting applications in the Medina, OH area for the following position: Staff Nurse (RN), Med Surg. Nurses with experience in any of the following areas are strongly encouraged to apply: Cardiac patients, Couplet care, EKG monitoring, Educator, Fundal massage, Healing, Neuro patients, Oncology...

  • Registered Nurse

    2 weeks ago

    Medina, United States Incredible Health Full time

    Hospitals on Incredible Health are actively hiring and accepting applications in the Medina, OH area for the following position: Registered Nurse (RN), Med Surg. Nurses with experience in any of the following areas are strongly encouraged to apply: Cardiac patients, Couplet care, EKG monitoring, Educator, Fundal massage, Healing, Neuro patients, Oncology...

  • RN - General Medicine

    4 weeks ago

    Medina, United States Cleveland Clinic Full time

    Join Cleveland Clinic's Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75 years. Here, you will work with and learn from some...

  • RN - Stepdown Unit

    2 months ago

    Medina, United States Cleveland Clinic Full time

    PRN Registered Nurse (RN)  - Stepdown Unit  Join Cleveland Clinic’s Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75...

  • RN - Complex Medicine Unit

    1 month ago

    Medina, United States Cleveland Clinic Full time

    Join Cleveland Clinic's Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75 years. Here, you will work with and learn from some...

  • RN - Cardiac/Neuro Stepdown

    3 weeks ago

    Medina, United States Cleveland Clinic Full time

    Registered Nurse (RN) - Cardiac/Neuro Stepdown Join Cleveland Clinic’s Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75...

  • RN - General Medicine

    2 months ago

    Medina, United States Cleveland Clinic Full time

    Join Cleveland Clinic’s Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75 years. Here, you will work with and learn from...

  • RN - General Medicine

    2 months ago

    Medina, United States Cleveland Clinic Full time

    Join Cleveland Clinic’s Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75 years. Here, you will work with and learn from...

  • RN - General Medicine

    2 months ago

    Medina, United States Cleveland Clinic Full time

    Join Cleveland Clinic’s Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75 years. Here, you will work with and learn from...

  • RN - General Medicine

    3 weeks ago

    Medina, United States Cleveland Clinic Full time

    Join Cleveland Clinic’s Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75 years. Here, you will work with and learn from...

  • RN - General Medicine

    2 months ago

    Medina, United States Cleveland Clinic Full time

    Join Cleveland Clinic’s Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75 years. Here, you will work with and learn from...

  • RN - General Medicine

    2 months ago

    Medina, United States Cleveland Clinic Full time

    Join Cleveland Clinic’s Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75 years. Here, you will work with and learn from...

  • PRN RN Hospital

    2 months ago

    Medina, United States Cleveland Clinic Full time

    Join Cleveland Clinic's Medina Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 148-bed community-based hospital has been providing the communities in and around Medina County with top-quality patient care for over 75 years. Here, you will work with and learn from some...