MDS Coordinator: LTC Reimbursement & Compliance

Cantex Continuing Care Network; Cedar Hill (TX); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Competitive pay

Bonus opportunities

Health insurance (medical, dental, and

Life insurance

401(k) with company match

PTO/Sick leave

Career growth opportunities

Supportive culture

Job summary

Cantex Continuing Care Network seeks an experienced MDS Coordinator to ensure accurate and compliant completion of the RAI process, supporting Medicare/Medicaid reimbursement. You will supervise MDS assessments, documentation accuracy, care plan coordination, and regulatory compliance to uphold high-quality resident care.

The role emphasizes interdisciplinary collaboration and aligning reimbursement with clinical delivery and state/federal guidelines.

Qualifications

• A current, valid Texas nursing license is required (RN, LVN).
• At least 2 years of LTC experience preferred.
• Must have an Acknowledgement of Completion Certificate through the HHSC RUG Online Training for Nursing Facilities.
• Must complete the American Association of Nurse Assessment Coordinators (AANAC) RAI Certification within 1 year of employment.
• Ability to effectively communicate, direct, and at times, delegate tasks.
• Ability to read, write, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
• Ability to write reports, nursing/Patient progress notes, and nursing procedures.
• Ability to effectively present information and respond to questions from department heads, customers, (Patients, family members, physicians, etc.) and the public.

Responsibilities

• Maintains compliance with all State and Federal Medicaid and/or Medicare rules, regulations, and published interpretations.
• Participates in the assessment of pre-admission paperwork to ensure Patient meets qualifying medical necessity determination.
• Attends standup meetings every weekday morning.
• Coordinates the Weekly Reimbursement Meeting with the Interdisciplinary Team Members to ensure proper Medicare and/or Medicaid reimbursement to match care delivery.
• Audit the Clinical Record to ensure appropriate documentation for actual care delivery. Educates and trains staff on documentation guidelines.
• Obtains Medicare qualifying diagnosis (es) on Medicare Part A Patients and updates diagnosis for each change in diagnosis.
• Initiates and updates the physician certifications for each Medicare Part A Patient.
• Completes all Minimum Data Set (MDS) assessments within the allotted time frame for each Medicare and/or Medicaid Patient.
• Reviews the 24-hour Nursing report to capture possible change in condition of a Patient.
• Prepares for all Medicaid audits.
• Tracks Patient benefit days, validates daily census and coordinates information with Financial Manager to ensure accurate billing.
• Achieves at least budgeted rates expectation.
• Has reviewed Cantex Continuing Care Network Continuing Care Network Clinical Policies and Procedures for Abuse Prevention and knows the employees responsibility to enforce it.
• Supports and upholds the Patient Care Management Systems as well as the Financial Management Systems.
• Responsible for assuring patient/resident safety.
• Performs other duties and/or tasks as assigned.

Skills

Strong communication

Documentation accuracy

Team coordination

Reading/writing ability

Analytical thinking

Education

Texas nursing license (RN/LVN)

AANAC RAI Certification

HHSC RUG Online Training certificate

Tools

AANAC RAI Certification

Job description

Cantex Continuing Care Network seeks an experienced MDS Coordinator to ensure accurate and compliant completion of the RAI process, supporting Medicare/Medicaid reimbursement. You will supervise MDS assessments, documentation accuracy, care plan coordination, and regulatory compliance to uphold high-quality resident care.

The role emphasizes interdisciplinary collaboration and aligning reimbursement with clinical delivery and state/federal guidelines.