Clinical Reimbursement Coordinator

Genesis Healthcare; Claremont (NH); On-site; USD 62,000 - 65,000; Full time

Benefits offered by this job

Health, Dental, Vision

Company-paid life insurance

401K

Paid Time Off

On-Demand Pay

Tuition, Travel, and Wireless Service

Employee Assistance Program

Employee Foundation

Job summary

Genesis HealthCare’s Elm Wood Center is seeking a Clinical Reimbursement Coordinator (MDS) with an RN license to manage MDS schedules, ensure accurate case-mix and RUGs categorization, and support billing accuracy. This role requires familiarity with Medicare/Medicaid reimbursement and MDS processes.

Ideal candidates will have long-term care nursing experience, BLS/CPR certification, and the ability to educate staff on MDS terminology while coordinating with the business office.

Qualifications

• Must be a graduate of an accredited School of Nursing with current RN licensure.
• 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).

Responsibilities

• Maintain an accurate schedule of all MDS assessments and ensure timely submission, including OBRA and OSRA requirements.
• Perform concurrent MDS review to ensure appropriate RUGs category through clinical information capture.
• Communicate case-mix data required for billing to the Business Office (RUGs, modifiers, state scores).
• Serve as nursing center resource for MDS/RUGs and state case-mix systems, providing staff education on MDS terminology.

Skills

MDS knowledge

Case management

Nursing experience

Education

RN licensure

Accredited School of Nursing

Tools

MDS/RUGs systems

Job description

Overview

Elm Wood Center is Hiring a Clinical Reimbursement Coordinator (MDS)

Come join our amazing team!

Under New Leadership

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 believe in fostering 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

• Maintain an accurate 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 OSRA required assessments.
• Perform concurrent MDS review to insure appropriate RUGs category is achieved through the capture of appropriate clinical information and in this process identify opportunities to enhance reimbursement.
• Communicate case-mix data required for billing to the Business Office such as RUGs categories, modifiers, state case-mix scores, etc.
• Serve as the nursing center resource for MDS/RUGs and state case-mix systems providing staff case-mix education and instruction on MDS terminology and format.

Qualifications

• Must be a graduate of an accredited School of Nursing with current RN 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

• Variable compensation plans
• Tuition, Travel, and Wireless Service Discounts
• Employee Assistance Program to support mental health
• Employee Foundation to financially assist through unforeseen hardships
• Health, Dental, Vision, Company-paid life insurance, 401K, Paid Time Off
• Free 24/7 virtual health care provided by licensed doctors for all Anthem medically-enrolled employees and their immediate family members
• On-Demand Pay Program that allows for instant access to a portion of the money you’ve already earned

We also offer several voluntary insurances such as:

• Pet Insurance
• Term and Whole Life Insurance
• Short-term Disability
• Hospital Indemnity
• Personal Accident
• Critical Illness
• Cancer Coverage

Restrictions apply based on collective bargaining agreements, applicable state law and factors such as pay classification, job grade, location, and length of service.

Posted Salary Range

USD $45.00 - USD $47.00 /Hr.

Genesis HealthCare, Inc. and all affiliated entities (collectively “Genesis”) has a strong commitment to diversity that is fully supported and practiced by our officers and leadership team. Genesis provides equal employment opportunities to all employees and applicants for employment without regard to actual or perceived race, color, religion, gender, gender expression, gender identity, sex, sexual orientation, HIV status, national origin, age, disability, marital status, pregnancy, ancestry, citizenship, genetic information, amnesty, military status or status as protected veterans, or any other legally protected characteristic. Genesis is an Affi…