Clinical Reimbursement Specialist Regional

Life Care Centers of America; St. Louis (MO); On-site; USD 60,000 - 80,000; Full time

Job summary

Life Care Centers of America in St. Louis is seeking a Clinical Reimbursement Specialist responsible for ensuring accurate monetary reimbursements related to patient services covered by insurance. The ideal candidate is a registered nurse with an active state license and MDS, RAI experience, who demonstrates excellent customer service and teamwork.

This role requires adherence to laws, regulations, and Life Care standards while maintaining a positive attitude towards patients.

Qualifications

• Registered nurse with an active state license and MDS and RAI experience.
• Knowledgeable of procedures governing post acute care facilities.
• Excellent customer service and positive patient interaction.

Responsibilities

• Ensure correct monetary reimbursement for services to patients.
• Assist in the evacuation of patients when necessary.
• Communicate effectively within an interdisciplinary team.

Skills

Independent decision-making

Knowledge of laws and regulations

Customer service

Interpersonal communication

Education

Active state nursing license

MDS and RAI experience

Job description

Overview

Position Summary. 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

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’s Code of Conduct and completes mandatory Code of Conduct and other appropriate compliance training

Essential Functions

• Exhibit excellent customer service and a positive attitude towards patients
• Assist in the evacuation of patients
• Demonstrate dependable, regular attendance
• 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

Equal Opportunity

An Equal Opportunity Employer