Clinical Reimbursement Coordinator, RN

About the role

We are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in the long‑term care industry, we foster a collaborative, inclusive, and supportive work environment where every team member is valued and empowered to make a difference. Whether you’re an experienced professional or just starting your career, we offer opportunities for growth, development, and advancement in a range of roles. Join us in our mission to enhance the well‑being of our patients and residents while making a meaningful impact in the communities we serve.

Responsibilities

• Manage the overall process and tracking of all Medicare/Medicaid case‑mix documents to ensure appropriate reimbursement for services provided within nursing.
• Maintain an accurate schedule of all MDS assessments, including proper reference dates throughout the patient stay.
• Ensure accurate and timely submission of MDS assessments, including case‑mix, OBRA, and OSRA required assessments.
• Perform concurrent MDS review to achieve appropriate RUGs categories by capturing relevant clinical information and identifying opportunities to enhance reimbursement.
• Communicate case‑mix data required for billing to the Business Office (e.g., RUGs categories, modifiers, state case‑mix scores).
• Serve as the nursing center resource for MDS/RUGs and state case‑mix systems, providing staff education and instruction on MDS terminology and format.

Qualifications

• Graduate of an accredited School of Nursing with current RN licensure in the state of employment.
• At least one year of long‑term care clinical nursing experience.
• Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization, and/or case management is highly desirable.
• Current BLS/CPR certification (excluding ALFs/ILFs).

Benefits

• Variable compensation plans
• Tuition, travel, and wireless service discounts
• Employee Assistance Program for mental health support
• Employee Foundation assistance for unforeseen hardships
• Health, dental, vision, company‑paid life insurance, 401(k), and paid time off
• Free 24/7 virtual health care for Anthem medically‑enrolled employees and immediate family members
• On‑demand pay program for instant access to earned wages
• Voluntary insurances: pet, term and whole life, short‑term disability, hospital indemnity, personal accident, critical illness, cancer coverage (subject to restrictions)

Pay

Posted Salary Range: USD $50.50 – USD $50.50 per hour.