RN/LPN MDS Coordinator / Clinical Reimbursement Experienced

MDS Coordinator / Clinical Reimbursement

The MDS Coordinator / Clinical Reimbursement - RN/LPN manages the overall process and tracking of all Medicare/Medicaid case-mix documents to ensure appropriate reimbursement for all services provided within the nursing. Key responsibilities include:

• Maintains the schedule of all MDS assessments to include the proper reference dates throughout the patient stay and ensures the accurate and timely submission of the MDS assessments including case-mix, OBRA and PDPM required assessments.
• Performs concurrent MDS review to ensure appropriate HIPPS category is achieved through the capture of appropriate clinical information and in this process identifies opportunities to enhance reimbursement.
• Collaborates with facility staff to assist with ensuring accurate/complete documentation to support accurate coding of MDS assessments and prevent revenue recoupment on audits.
• Communicates case-mix data required for billing to the Business Office such as HIPPS categories, modifiers, state case-mix scores, etc.
• Serves as the nursing center resource for MDS/HIPPS and state case-mix systems providing staff case-mix education and instruction on MDS terminology and format.
• Ensures the development of accurate and resident specific care plans to support quality of care and reimbursement.

Requirements

• Must be a graduate of an accredited School of Nursing with current RN/LPN licensure in the state in which employment occurs is required.
• One year of long term care clinical nursing experience is required.
• Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable.
• Must maintain current BLS/CPR certification (excluding ALFs/ILFs).

Benefits

• 401(k)
• Health/Dental insurance
• Vision
• Life insurance
• Vacation
• Holidays
• Paid Sick Time