Regional MDS & Reimbursement Specialist

INNOVATIVE NURSE CONSULTING LLC; Dallas (TX); On-site; USD 80,000 - 110,000; Full time

Job summary

INNOVATIVE NURSE CONSULTING LLC seeks a Regional Clinical Reimbursement Specialist to travel daily to facilities, coordinating clinical reimbursement in line with state and federal requirements and company policy to ensure resident care quality and safety.

You will report to the Director of Clinical Reimbursement, overseeing MDS program development, clinical planning, and operations, while supporting regional and facility teams in all care management aspects.

Qualifications

• Analytical thinking to synthesize complex data from records.
• Problem solving to resolve regulatory and clinical issues.
• Clear written and verbal communication with care teams.
• Attention to detail to ensure accuracy of documentation and coding.

Responsibilities

• Review medical records to determine required supporting documentation.
• Nurse-led review of patient records for regulatory compliance.
• Manage tasks to meet deadlines in a production-oriented setting.
• Develop appeal arguments using clinical evidence and regulations.
• Support regulatory and clinical aspects of the MDS program.
• Attend mandatory in-service trainings and workshops.

Skills

Analytical

Problem Solving

Communication

Quality

Character

Organizational Support

Dependability

Education

RN licensure (state)

Job description

INNOVATIVE NURSE CONSULTING LLC seeks a Regional Clinical Reimbursement Specialist to travel daily to facilities, coordinating clinical reimbursement in line with state and federal requirements and company policy to ensure resident care quality and safety.

You will report to the Director of Clinical Reimbursement, overseeing MDS program development, clinical planning, and operations, while supporting regional and facility teams in all care management aspects.