Clinical Reimbursement Coordinator, RN

West State Street; Milford (DE); On-site; USD 85,000 - 103,000; Full time

Benefits offered by this job

Variable compensation plans

Tuition, Travel, and Wireless Service 

Employee Assistance Program to support

Employee Foundation to assist through\

Health, Dental, Vision, 401K, Paid PTO

Free 24/7 virtual health care

On‑Demand Pay Program

Job summary

West State Street is seeking an MDS Coordinator - RN in Delaware to lead the timely, accurate completion of MDS assessments and review care plans across clinical teams. You will ensure compliance with high care standards in a long-term care setting.

The role requires an active RN license and at least one year of LTC nursing experience; LPNs with MDS experience may be considered. Join our team to support residents and families with exceptional care.

Qualifications

• Must be a graduate of an accredited School of Nursing with current RN licensure.
• LPNs with MDS experience may be considered.
• At least one year of long‑term care nursing experience is required.

Responsibilities

• Manage the overall process and tracking of Medicare/Medicaid case-mix documents for reimbursement.
• Conduct concurrent MDS reviews to maximize RUG categories.
• Integrate information from nursing, dietary, social services, and physician services to ensure reimbursement.

Education

RN licensure (Registered Nurse)

LPN with MDS experience

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 Coordinator - RN is responsible for the timely and accurate completion of the MDS treatment assessment tool and for reviewing care plans and their delivery for factors specific to our patients/residents such as physical, cognitive, and socialization factors to ensure compliance with our high standards of care.

• Manage the overall process and tracking of all Medicare/Medicaid case‑mix documents to assure appropriate reimbursement for services provided within the nursing center.
• Conduct concurrent MDS reviews to assure achievement of maximum allowable RUG categories.
• Integrate information from nursing, dietary, social services, restorative, rehabilitation, and physician services to ensure appropriate reimbursement.

Qualifications

• Must be a graduate of an accredited School of Nursing with current Registered Nurse (RN) licensure. LPNs with MDS experience may be considered.
• At least one year of long‑term care nursing experience is required.

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.

USD $94,000.00 - USD $94,000.00 /Yr.