MDS Coordinator (PCC) LVN

SAN-Rem; Richardson (TX); On-site; USD 64,000 - 86,000; Full time

Job summary

SAN-Rem is seeking a dedicated MDS Coordinator in Texas to ensure proper Medicare/Medicaid reimbursement through the RAI process and maintain high standards of patient care in a regulated environment.

The role requires an active Texas nursing license (RN/LVN) and LTC experience, with certification requirements to be completed within a year. Strong communication, writing, and organizational skills are essential for success.

Qualifications

• Texas nursing license (RN or LVN) is required.
• At least 2 years of LTC experience preferred.
• Must complete HHSC RUG Online Training for Nursing Facilities (Acknowledgement of Completion).
• AANAC RAI Certification within 1 year of employment.

Responsibilities

• Ensure compliance with State and Federal Medicaid/Medicare rules and interpretations.
• Participate in assessment of pre-admission paperwork for medical necessity.
• Attend standup meetings every weekday morning.
• Coordinate Weekly Reimbursement Meeting with Interdisciplinary Team for proper reimbursement.
• Audit Clinical Records to ensure accurate documentation of care.
• Educate staff on documentation guidelines.
• Obtain Medicare qualifying diagnoses for Part A patients and update changes.
• Initiate and update physician certifications for Medicare Part A patients.
• Complete all MDS assessments within required timeframes.
• Review 24-hour Nursing report for changes in condition.
• Prepare for Medicaid audits and track patient benefit days.
• Support and uphold Patient Care and Financial Management Systems.

Skills

Communication skills

Reading/Writing/Analysis

Report writing

Presentation skills

Team coordination

Education

RN/LVN Nursing License

AANAC RAI Certification

Tools

HHSC RUG Online Training

Job description

$5.000 SIGN-ON BONUS !!Job Summary:The overall purpose of the MDS Coordinator position is to ensure appropriate reimbursement of Medicare and/or Medicaid Patients through the Patient Assessment Instrument (RAI) process. Assists in the management of quality Patient care on a continuing basis in accordance with federal and state standards and as may be directed by the Administrator or Director of Nursing.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, business correspondence, 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.Essential Functions: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.#HPWe are an Equal opportunity employer; We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.Please visit cantexcc.com for more information on this location.