Registered Nurse Assessment Coordinator (RNAC)

Responsibilities

• Oversees the completion and tracking of Prospective Payment System (PPS) Minimum Data Set (MDS) assessments.
• Ensures accurate and timely completion of all MDS Assessments including OBRA and Medicare PPS.
• Maintains an accurate schedule of all MDS assessments and ensures proper reference dates.
• Verifies electronic submission of MDS and performs corrections when necessary.
• Maintains appropriate records and coordinates interdisciplinary participation in completing the MDS.
• Schedules resident care conferences and ensures completion of all MDS reviews prior to care conference.
• Aids disciplines in the care planning process by ensuring MDS information is completed timely and CAAs are thoroughly analyzed.
• Ensures Medicare documentation follows federal and state guidelines and is completed timely, including physician certification/Recertification, Traditional Medicare and Medicare Advantage non-coverage letters.
• Monitors activities of daily living for accuracy and provides education when warranted.
• Conducts daily PPS meeting, weekly Medicare/Insurance and Quarterly Clinical Review meetings.
• Coordinates the monthly billing process, including the triple check meeting, attested billing report, and HMO log.
• Assists with the appeal process to ensure timelines are met and appeals are submitted.
• Captures Medicaid Picture Date submissions in a timely manner.
• Coordinates managed care process, including submitting timely updates and obtaining ongoing authorizations.