MDS Coordinator - RN - LVN

Cantex Continuing Care Network; Pearland (TX); On-site; USD 55,000 - 70,000; Full time

Benefits offered by this job

Competitive wages

401k with match

Medical, Dental, Vision & Supplemental

Job summary

Cantex Continuing Care Network is seeking an experienced MDS Coordinator in Pearland, TX to oversee Medicare/Medicaid patient assessments and ensure accurate reimbursement through the RAI process. The role supports quality patient care while complying with federal and state standards.

Responsibilities include coordinating the weekly reimbursement meetings with the interdisciplinary team, auditing records for documentation, obtaining qualifying diagnoses, preparing physician certifications, and

Qualifications

• Texas nursing license (RN or LVN) required.
• At least 1 year of MDS experience required.
• At least 2 years LTC/SNF experience preferred.
• Completion of HHSC RUG Training Acknowledgement.
• AANAC RAI Certification within 1 year of employment.
• Strong communication and documentation skills.

Responsibilities

• Maintains compliance with Medicaid/Medicare rules and interpretations.
• Participates in assessment of pre-admission paperwork for medical necessity.
• Attends standup meetings every weekday morning.
• Coordinates Weekly Reimbursement Meeting with the interdisciplinary team.
• Audits clinical records and trains staff on documentation guidelines.
• Obtains Medicare qualifying diagnoses and updates changes.
• Initiates and updates physician certifications for Medicare Part A.
• Completes all MDS assessments within the allotted time frame.
• Reviews the 24-hour Nursing report for possible change in condition.
• Prepares for Medicaid audits and ensures accurate billing.

Skills

Nursing license

MDS experience

LTC/SNF experience

Communication

Documentation

Job description

Overview

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.

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 employee’s 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.

Qualifications

• A current, valid Texas nursing license is required (RN, LVN)
• At least 1 year of MDS experience is required
• At least 2 years of LTC/SNF experience is 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.

Benefits/EEO

What We Offer You

• Competitive Wages
• 401k with match
• Medical, Dental, Vision & Supplemental Insurance
• Vacation, Sick, Personal Holiday & Paid Holidays
• Short-Term Disability
• Life Insurance
• Tuition & CEU Reimbursement
• Rewards & Recognition Program

EEOC

We are an Equal Opportunity Employer. We offer an excellent benefit plan to include 401(k) with match, CEU reimbursement, vacation, sick time, holidays, medical, dental, and supplemental insurance plans, as well as a highly competitive compensation package.