Clinical Reimbursement Coordinator, RN

Genesis HealthCare; Albuquerque (NM); On-site; USD 92,000 - 104,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Company-paid life insurance

401K

Paid Time Off

On-Demand Pay

Job summary

Genesiscareers is seeking an MDS Nurse -- RN to oversee Medicare/Medicaid case-mix documentation and ensure accurate reimbursement for services provided in a long-term care setting. You will manage MDS schedules, perform concurrent reviews, and act as the center's resource for MDS terminology and practices.

The ideal candidate will hold an RN license, have at least one year in long-term care, and be familiar with Medicare/Medicaid processes. BLS/CPR certification is required.

Qualifications

• Must have RN licensure in the state of employment.
• Minimum of one year of long-term care nursing experience.
• Experience with Medicare/Medicaid reimbursement and MDS processes is desirable.
• Maintain current BLS/CPR certification.

Responsibilities

• Manage the MDS process and documentation to ensure appropriate reimbursement.
• Maintain schedule of MDS assessments with reference dates.
• Conduct concurrent MDS reviews to optimize RUG categories and reimbursement.
• Communicate case-mix data to Business Office and educate staff on MDS terminology.

Skills

RN licensure

Long-term care experience

MDS/RUGs familiarity

Medicare/Medicaid reimbursement

BLS/CPR certification

Education

Accredited School of Nursing

Job description

Overview

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

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 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 24/7virtual health careprovided by licensed doctorsforall Anthemmedically-enrolled employees and theirimmediate 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 $91,520.00 - USD $104,000.00 /Yr.