MDS LPN: Reimbursement & Compliance Expert

Garden Gate Health Care Facility; Buffalo (NY); On-site; USD 67,000 - 69,000; Full time

Benefits offered by this job

PTO

Weekly or Same-Day Pay

Health, Dental, and Vision Insurance

Life Insurance

Employee Referral Bonus

Retirement Savings Options

Job summary

Garden Gate Health Care Facility in Cheektowaga, NY, seeks an MDS LPN to support Medicare, PDPM, and long-term care reimbursement while ensuring accurate MDS completion and regulatory compliance.

This salaried role covers a full-time daytime schedule with a competitive annual salary range of $66,560 to $68,640, plus benefits. The position is part of The McGuire Group network, focused on compassionate, resident-centered care.

Qualifications

• Graduate of an LPN Vocational Program; Bachelor's Degree in Nursing preferred.
• Minimum 2 years of long-term care experience; 4 years preferred.
• Current unrestricted NYS LPN license.
• Experience with MDS, PDPM, reimbursement, and quality measures.
• Strong understanding of Medicare, Medicaid, Managed Care, and third-party payer requirements.
• Excellent time management, organizational, and problem-solving skills.
• Strong communication and interpersonal abilities.
• Ability to manage multiple priorities and meet deadlines.
• Knowledge of long-term care regulations, reimbursement methodologies, and standards of care.
• Ability to educate and support interdisciplinary teams.

Responsibilities

• Educate facility staff on Medicare, Medicaid, PDPM, and reimbursement.
• Assist with certification procedures and reimbursements.
• Collaborate with claims review units and third-party payers.
• Review denied claims and audits.
• Monitor reimbursement compliance.
• Analyze reimbursement data and utilization trends.
• Review authorizations and third-party requirements.
• Provide ongoing reimbursement training.
• Complete PDPM reviews on admission and readmission.
• Review MDS assessments for accuracy and compliance.
• Gather documentation for CMS audits.
• Review physician documentation and ICD-10 coding.
• Conduct MDS integrity reviews.
• Perform additional duties as assigned.

Skills

MDS Knowledge

PDPM

Long-term Care

Regulatory Compliance

Reimbursement

Education

LPN Vocational Program

Bachelor's Degree in Nursing

Job description

Garden Gate Health Care Facility in Cheektowaga, NY, seeks an MDS LPN to support Medicare, PDPM, and long-term care reimbursement while ensuring accurate MDS completion and regulatory compliance.

This salaried role covers a full-time daytime schedule with a competitive annual salary range of $66,560 to $68,640, plus benefits. The position is part of The McGuire Group network, focused on compassionate, resident-centered care.