Clinical Reimbursement Coordinator, RN

Genesis Administrative Services LLC; Albuquerque (NM); On-site; USD 52,348 - 61,992; Part time

Benefits offered by this job

Variable compensation plans

Health, Dental, Vision insurance

Employee Assistance Program

Job summary

A leading healthcare provider in Albuquerque is seeking a part-time MDS Nurse. This role involves managing the MDS process and ensuring accurate Medicare/Medicaid documentation. Candidates must be a graduate from an accredited nursing school with current RN licensure, and have experience in long-term care clinical nursing. The position offers a competitive pay range along with various employee benefits including tuition discounts, health plans, and an Employee Assistance Program.

Qualifications

• Must be a graduate of an accredited School of Nursing with current RN licensure in the state of employment.
• One year of long-term care clinical nursing experience is required.
• Experience with Medicare/Medicaid reimbursement, MDS completion, and case management is highly desirable.

Responsibilities

• Manage overall process and tracking of Medicare/Medicaid case-mix documents.
• Maintain and submit MDS assessments accurately and timely.
• Perform concurrent MDS reviews to ensure appropriate RUGs category is achieved.
• Communicate case-mix data for billing purposes.
• Educate staff on MDS terminology and case-mix systems.

Skills

MDS completion

Medicare/Medicaid reimbursement

Clinical resource utilization

Long-term care clinical nursing

BLS/CPR certification

Education

Graduate of an accredited School of Nursing

Current RN licensure

Job description

Overview

Ladera Care Center seeks a part time MDS Nurse! Prior MDS experience and ability to work weekday shifts required.

At Genesis Healthcare, 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 are 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

• The MDS Nurse -- RN manages the overall process and tracking of all Medicare/Medicaid case‑mix documents to ensure appropriate reimbursement for all services provided within the nursing.
• 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.
• 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 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 $38.00 - USD $45.00 / Hr.