Clinical Reimbursement Coordinator, RN

Genesis Administrative Services LLC; Sinking Spring (Berks County); On-site; USD 45,460 - 64,747; Full time

Benefits offered by this job

Variable compensation plans

Tuition and Travel Discounts

Employee Assistance Program

Health, Dental, and Vision Insurance

401K and Paid Time Off

Free virtual health care

On-Demand Pay Program

Pet Insurance

Term and Whole Life Insurance

Short-term Disability and Accident Coverage

Critical Illness and Cancer Coverage

Job summary

A leading healthcare provider in Sinking Spring is looking for an MDS Nurse - RN to manage Medicare and Medicaid case-mix documents. Responsibilities include ensuring accurate MDS assessments, conducting concurrent reviews, and providing staff education on MDS systems. Candidates must have an accredited nursing degree, one year of long-term care nursing experience, and maintain BLS/CPR certification. This position offers competitive hourly compensation and a comprehensive benefits package.

Qualifications

• Must be a graduate of an accredited School of Nursing with RN licensure.
• One year of long-term care clinical nursing experience is required.
• Experience with Medicare and Medicaid reimbursement is highly desirable.
• Current BLS/CPR certification must be maintained.

Responsibilities

• Manage overall process of Medicare/Medicaid case-mix documents.
• Maintain an accurate schedule of MDS assessments.
• Perform concurrent MDS reviews to achieve appropriate RUGs category.
• Communicate relevant case-mix data for billing.

Skills

Clinical nursing experience

Medicare/Medicaid reimbursement knowledge

MDS completion

Case management

Education

Graduation from an accredited School of Nursing

Job description

Overview

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'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

• 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 $40.00 - USD $40.00 /Hr.