MDS COORDINATOR - (PCC) LVN (23445)

Cantex Continuing Care Network; Plano (TX); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

401K with match

CEU reimbursement

Paid vacation

Job summary

Cantex Continuing Care Network is seeking an MDS Coordinator at our Skilled Nursing facility in Plano, TX. The role focuses on ensuring proper reimbursement for Medicare/Medicaid patients through the RAI process and supporting ongoing quality of care in compliance with federal and state standards.

Qualified candidates must hold a current Texas nursing license (RN or LVN), have 2+ years of LTC experience, and obtain RUG training and AANAC RAI certification within 1 year.

Qualifications

• Requires current Texas nursing license (RN or LVN).
• At least 2 years of long-term care experience preferred.
• Must complete HHSC RUG Online Training for Nursing Facilities.
• Must obtain AANAC RAI certification within 1 year of employment.
• Ability to communicate, direct, and delegate tasks.
• Ability to read, write, analyze, and interpret general business materials and regulations.
• Ability to write reports and nursing documentation.
• Ability to present information to department heads, patients, families, physicians, and the public.

Responsibilities

• Ensure compliance with State/Federal Medicaid and Medicare rules.
• Assess pre-admission paperwork for medical necessity.
• Attend daily standup meetings.
• Coordinate Weekly Reimbursement Meeting with Interdisciplinary Team.
• Audit Clinical Records and train staff on documentation guidelines.
• Obtain Medicare qualifying diagnoses for Part A patients.
• Initiate and update physician certifications for Medicare Part A patients.
• Complete all MDS assessments within required timeframes.
• Review 24-hour Nursing reports for changes in condition.
• Prepare for Medicaid audits and track patient benefit days with Finance for accurate billing.
• Aim to meet budgeted rates and enforce policies.

Skills

Communication skills

Reading/writing/analysis

Report writing

Delegation

Education

Texas RN/LVN license

RUG Online Training (HHSC)

AANAC RAI certification (within 1 year)

Job description

Job Location: Skilled Nursing at Carrara - Plano, TX 75093

Position Type: Full Time

Job Category: Nursing

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. It also 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.
• Audits 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.

We 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.