MDS Coordinator - RN - LVN

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

Benefits offered by this job

401k with match

Medical, Dental, Vision & Supplemental

Vacation, Sick, Personal Holiday &Paid

Short-Term Disability

Life Insurance

Tuition & CEU Reimbursement

Rewards & Recognition Program

Job summary

Cantex Continuing Care Network in Plano, TX is seeking an MDS Coordinator to manage the MDS/RAI process and support Medicare/Medicaid reimbursement while ensuring high-quality patient care in accordance with regulatory standards.

Responsibilities include ensuring compliance with state and federal rules, coordinating the weekly reimbursement meeting, auditing clinical records, obtaining qualifying diagnoses, and training staff on documentation to optimize care and billing accuracy.

Qualifications

• MDS experience and knowledge of the RAI process.
• Texas RN/LVN license in good standing is required.
• Onsite LTC experience preferred.
• Must complete AANAC RAI Certification within 12 months.
• Must complete HHSC RUG Online Training for Nursing Facilities."

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 Interdisciplinary Team Members to ensure proper Medicare/Medicaid reimbursement to match care delivery.
• Audits the Clinical Record to ensure appropriate documentation for actual care delivery; educates staff on documentation guidelines.
• Obtains Medicare qualifying diagnoses for Part A patients and updates diagnoses as needed.
• Initiates and updates physician certifications for each Medicare Part A patient.
• Completes all MDS assessments within required timeframes for Medicare/Medicaid patients.
• Reviews 24-hour Nursing report to detect changes in patient condition.
• Prepares for Medicaid audits.
• Tracks patient benefit days, validates daily census, and coordinates with Financial Manager for accurate billing.
• Strives to achieve budgeted rate targets.

Skills

MDS experience

Texas nursing license

LTC experience

AANAC RAI certification

HHSC RUG training completion

Analytical/reporting

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.

#Corp

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 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.