Join to apply for the MDS Nurse (RN) - Sign on Bonus role at Williamstown Commons
We are looking for a Clinical Reimbursement Coordinator (MDS RN) to join our caring, compassionate team. The primary purpose of this position is to manage all aspects of the MDS process, promoting and ensuring the highest level of clinical integrity to capture appropriate reimbursement for all reasonable and necessary services provided. All responsibilities will be conducted in a manner that exhibits the Integritus Healthcare mission, vision, and core values. UP TO $3000 SIGN ON BONUS! Receive a referral bonus when referring nurse colleagues (CNA, LPN, or RN)!
Essential Job Functions:
- Perform independent and/or suggested affiliate level, clinical and financial audits as warranted.
- Identify and assist with educational opportunities through audit, tracking, trending, and analyzing relevant patient data with supervisor guidance and support.
- Strategic planning related to ARDs to optimize appropriate revenue systems.
- Ensure IDT compliance with state/federal requirements and timeframes related to MDS, billing, and care planning.
- Provide high-level interpretation of revenue-related data as requested.
- Identify revenue-related risks associated with missing, irrelevant, erroneous clinical documentation and assist with action plans.
- Assist with orientation and education for CRCs and other IDT members related to MDS and reimbursement processes.
- Provide ongoing education and communication with IDT regarding current state and federal regulation systems driven by the MDS.
- Review clinical charts to determine skilled need and assist with determining appropriate Length of Stay.
- Attest to completion of MDS at section Z and sign MDS completion for LPNs in the department.
- Develop and revise care plans as per facility protocol and lead/attend CP meetings.
- Conduct regular meetings related to Revenue and ensure timely managed care updates.
- Assist with maintenance, risk, and education related to 5 STAR Quality Measures/Value Based Purchasing and Quality Reporting programs.
- Provide information for Additional Documentation Requests (ADR) and perform other related duties as assigned.
Qualifications:
- MA licensed nurse with 3+ years of reimbursement or similar experience in LTC.
- Computer literacy (Word, Excel, PowerPoint, Outlook).
- Experience with EMR (NTT) software is a plus.
- Effective written, verbal, and technological communication skills.
- Excellent organization, communication, and presentation skills.
- Deadline driven, detail-oriented with strong analytical skills.
- Knowledge of state and federal regulations governing MDS and billing within a nursing facility (CMI/PDPM/Managed care, QRP/VBP).
- Ability to communicate with and support other IDT members at the affiliate level.
- Ability to apply knowledge of Medicaid and Medicare CMI/PDPM methodologies.
- Independent, self-directed work ethic.
- Excellent interpersonal, time management, and customer relations skills.
- Proficiency in English language (reading, writing, speaking).
Education:
Graduate of an accredited RN program. RN license in Massachusetts is required.