MDS Solutions - Clinical Reimbursement Specialist

MDS Solutions; St. Louis (MO); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading company in rehabilitation services seeks a Clinical Reimbursement Specialist to support clients with reimbursement systems and RAI assessments. This role involves strong clinical expertise, flexibility, and leadership skills to optimize healthcare operations and ensure compliance. Join a dynamic team offering comprehensive benefits and career development in a supportive environment.

Benefits

Flexible work environment

Comprehensive benefits

Continuing education

401K

Qualifications

• 5+ years of clinical experience including 3+ years in RAI.
• Current RN license and active RAC-CT certification.
• Strong leadership and interpersonal skills.

Responsibilities

• Conduct RAI assessments and develop care plans.
• Offer guidance to optimize operations for healthcare agencies.
• Deliver high-quality services including reimbursement optimization.

Skills

Critical thinking

Clinical judgment

Quality improvement

Leadership

Interpersonal skills

Education

Bachelor’s degree in nursing

RN license

RAC-CT certification

Job description

MDS Solutions - Clinical Reimbursement Specialist

Join to apply for the MDS Solutions - Clinical Reimbursement Specialist role at MDS Solutions.

MDS Solutions, a division of Key Rehabilitation, is seeking energetic, self-driven team members for our remote MDS division as a Clinical Reimbursement Specialist.

Role Overview

The Clinical Reimbursement Specialist (CRS) supports clients through project work such as conducting RAI assessments, developing care plans, and training MDS Coordinators on the Resident Assessment Instrument (RAI). The CRS reviews reimbursement systems for PDPM and Case Mix to ensure accurate reimbursement and supports contract coordination.

About Us

At Key Rehab, we innovate rehab services with a focus on effective, affordable therapy. We prioritize clear communication, patient care, staff satisfaction, and exceeding expectations for patients, families, healthcare providers, and businesses.

We offer a flexible, engaging work environment with comprehensive benefits, including competitive pay, promotion opportunities, work-life balance, continuing education, health insurance, 401K, reimbursements, and more.

Key Responsibilities

• Serve as a trusted advisor to healthcare agencies, offering guidance to optimize operations.
• Assess, plan, develop, and implement reimbursement systems tailored to client needs.
• Provide consulting and technical expertise, including interim MDS management.
• Stay current on clinical standards, regulations, QM measures, and the RAI process.
• Deliver high-quality services including reimbursement optimization, staff training, research, and system analysis.
• Identify training needs and conduct staff education sessions.
• Operate within scope of work, maintaining client confidentiality and HIPAA compliance.

Minimum Qualifications

• Bachelor’s degree in nursing with at least 5 years of clinical experience, including 3+ years in RAI.
• Current RN license and active RAC-CT certification.
• Exceptional critical thinking, clinical judgment, and quality improvement skills.
• Strong leadership and interpersonal skills to foster team collaboration.

Key Rehab is an equal opportunity employer.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Business Development and Sales
• Industries: Hospitals and Healthcare