Clinical Reimbursement Specialist - RN

VI HEALTHY LIVING LTD; Santa Cruz (CA); On-site; USD 150,000 - 200,000; Part time

Job summary

An established industry player is seeking a Clinical Reimbursement Specialist (CRS) – RN to join their team. This part-time position focuses on collaborating with nursing staff to ensure compliance with federal regulations while managing resident assessments for optimal reimbursement. The role requires a dedicated professional with a strong background in nursing and regulatory compliance, who is passionate about providing quality care to seniors. Join a company known for its exceptional work environment and generous benefits, where your contributions will make a meaningful impact in the lives of older adults.

Benefits

Competitive pay

Exceptional benefits

Generous Paid Time Off

401k with company match

Paid maternity and paternity benefits

Award-winning training and development

Tuition Reimbursement

Luxury work environment

Meaningful and rewarding work

Qualifications

• Graduation from a School for Registered Nursing is required.
• Minimum 1 year of experience in an MDS/Clinical Reimbursement Nurse role preferred.

Responsibilities

• Collaborates with various disciplines to assist in completing MDS and RAI processes.
• Manages the overall resident assessment process for optimal reimbursement.

Skills

Communication Skills

Problem Solving

Regulatory Compliance Knowledge

Microsoft Office Proficiency

Interpersonal Skills

Education

Registered Nursing Degree

Tools

Microsoft Office

Job description

Overview

Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.

What We Offer:

• Competitive pay
• Exceptional benefits
• Generous Paid Time Off - start accruing on day one
• 401k with company match
• Paid maternity and paternity benefits
• Award-winning training and development
• Tuition Reimbursement
• Luxury work environment
• Meaningful and rewarding work

Vi at Palo Alto is located at 620 Sand Hill Road, Palo Alto CA 94304

Responsibilities

Clinical Reimbursement Specialist (CRS) – RN

Collaborates with the DON, CRM (where applicable) and various disciplines to assist in the completion of the Minimum Data Set (MDS), Resident Assessment Instrument (RAI), and all associated processes. With guidance and oversight from the DON or CRM (where applicable), the CRS ensures completion of the assessment within the timeframe as mandated by federal regulations and company policies. The CRS manages the overall resident assessment process and tracking of all Medicare/Managed Care/Medicaid case mix documents in order to ensure appropriate and optimal reimbursement for services provided within the Care Center. Responsibilities also include assisting with the coordination of resident care planning processes under the direction of the DON or CRM (where applicable). Performs other duties as assigned.

THIS IS A PART TIME POSITION.

Qualifications

Education and Experience:

• Education: Graduation from a School for Registered Nursing is required.
• Work Experience: Minimum 1 year of previous experience in an MDS/Clinical Reimbursement Nurse role is preferred.
• Licensure / Certification, where required:
  • Current State Licensure as a Registered Nurse in the state where practicing is required. Current CPR and Automated External Defibrillator (AED) certifications are required.
  • Current First Aid certification is required or must be willing and able to become First Aid certified. Food handlers certification, where required.

Key Competencies:

• Maintains a courteous and professional manner through interactions with others.
• Uses a resident and customer-focused approach to problem solving and goal setting.
• Uses discretion in handling confidential information, incorporating all Federal, State and local privacy and confidentiality requirements.
• Excellent knowledge of case-Mix, and the Federal Medicare PPS process as required.
• Thorough understanding of the Quality Indicator Process, and OBRA regulations.
• Must possess knowledge of regulatory compliance and Continuing Care Retirement Community operations.
• Good oral and written communication skills and ability to interface and maintain effective relationships with all departments and employees in a team-oriented environment.
• Computer proficiency using Microsoft Office.
• Must be sensitive to the needs of older adults and enjoy working with a senior population.

The application window is anticipated to close within 30 days of the date of the posting.

Pay Range

USD $46.60 - USD $58.26 /Hr.