CLINICAL REIMBURSEMENT COORDINATOR-RN

MountainOne; Pittsfield, Northern (MA, KY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Weekly pay

Generous time off

Exceptional health insurance

Job summary

Hillcrest Commons Nursing and Rehabilitation in Pittsfield, MA is seeking a Clinical Reimbursement Coordinator to manage all aspects of the MDS process and coordinate with clinical and administrative staff on Medicare admissions.

The role requires oversight of resident chart audits, communications with Medicare providers, and collaboration with Nursing Administration to ensure compliance and quality care. On-site position with opportunities for growth within a large health system.

Responsibilities

• Ensures accurate MDS completion in accordance with state and federal regulations.
• Review Medicare charts to determine coverage, communication on aspects of care to staff for documentation.
• Conduct team meetings to discuss care planning.
• Provide information as requested to Medicare intermediates, Mass Pro, or other insurance providers.
• Do PRI's when requested.
• Provide PEN Therapy usage forms monthly and certifications as required for gastrostomy feedings.
• Monitor necessary documentation for bed use.
• Perform other duties as assigned by the Director of Nursing or designee.

Job description

Come join this collaborative and innovated team. At Hillcrest Commons Nursing and Rehabilitationyou will enjoy WEEKLY pay, generous time off, exceptional health insurance and the ability to grow in your career.

Ready to love working again and be proud of where you work? Do you want to be valued and have an opportunity to make a meaningful impact? If you answered ‘yes,’ we can’t wait to introduce you to our team of dedicated, caring professionals.

Join one of the largest post-acute health care systems across Massachusetts, committed to fulfilling the health and residential needs of the population in the communities we serve.

As a clinical reimbursement coordinator, you will manage all aspects of the MDS process including Medicare and long term care assessments, scheduling and completion and works closely with clinical and administrative staff regarding Medicare admissions. Responsible for resident chart audits and reports to Nursing Administration.

Essential Job Functions

• Ensures accurate MDS completion in accordance with state and federal regulations.
• Review Medicare charts to determine coverage, communication on aspects of care to staff for documentation.
• Conduct team meetings to discuss care planning.
• Provide information as requested to Medicare intermediate, Mass Pro, or other insurance providers.
• Do PRI's when requested.
• Provide PEN Therapy usage forms monthly and certifications as required for gastrostomy feedings.
• monitor necessary documentation for bed use.
• Perform other duties as assigned by the Director of Nursing or designee.

Location: On-Site position at Hillcrest Commons, 169 Valentine Rd, Pittsfield MA