Clinical Reimbursement Specialist

Life Care Centers of America; Fishers (IN); On-site; USD 70,000 - 90,000; Full time

Job summary

Life Care Centers of America seeks a Clinical Reimbursement Specialist to ensure proper reimbursement for services through review of patient records and care programs, complying with laws and Life Care standards.

The role emphasizes collaboration with care teams, adherence to regulations, and maintaining confidentiality while upholding Life Care’s Code of Conduct and mandatory training requirements.

Qualifications

• Registered nurse with an active state license and MDS/RAI experience.
• Ability to make independent decisions when warranted.
• Knowledge of laws and regulations governing post-acute care facilities.

Responsibilities

• Exhibit excellent customer service and a positive attitude towards patients.
• Assist in the evacuation of patients.
• Concentrate and use reasoning skills and good judgment.
• Communicate and function productively on an interdisciplinary team.
• Read, write, speak, and understand the English language.

Skills

Independent decision making

Regulatory compliance

Interdisciplinary teamwork

Confidentiality

Code of Conduct training

Education

RN license with MDS & RAI experience

Job description

The Clinical Reimbursement Specialist ensures correct monetary reimbursement for any services offered to patients and residents covered by insurance programs by reviewing patient records and clinical care programs. in accordance with all applicable laws, regulations, and Life Care standards.

Education, Experience, and Licensure Requirements

• Registered nurse with an active state license and MDS and RAI experience.

Specific Job Requirements

• Make independent decisions when circumstances warrant such action
• Knowledgeable of practices and procedures as well as the laws, regulations, and guidelines governing functions in the post acute care facility
• Implement and interpret the programs, goals, objectives, policies, and procedures of the department
• Perform proficiently in all competency areas including but not limited to: patient rights, and safety and sanitation
• Maintains professional working relationships with all associates, vendors, etc.
• Maintains confidentiality of all proprietary and/or confidential information
• Understand and follow company policies including harassment and compliance procedures
• Displays integrity and professionalism by adhering to Life Care’sCode of Conductand completes mandatoryCode of Conductand other appropriate compliance training

Essential Functions

• Exhibit excellent customer service and a positive attitude towards patients
• Assist in the evacuation of patients
• Concentrate and use reasoning skills and good judgment
• Communicate and function productively on an interdisciplinary team
• Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours
• Read, write, speak, and understand the English language