Regional Reimbursement Consultant

Emerald Healthcare; United States; In loco; USD 95.000 - 120.000; Tempo pieno

Descrizione del lavoro

Emerald Healthcare is seeking an experienced Regional Reimbursement Consultant to provide oversight, education, and support to our skilled nursing facilities. This role focuses on maximizing reimbursement accuracy, ensuring regulatory compliance, and supporting facility MDS teams.

The position requires RN licensure, strong MDS/PDPM knowledge, and at least 5 years of reimbursement experience, with travel between facilities as needed.

Competenze

• Active RN license in good standing.
• Strong knowledge of MDS, PDPM, and Medicaid/CMI reimbursement.
• Minimum 5 years of MDS/reimbursement experience.
• Regional or multi-facility experience preferred.
• RAC-CT certification or other relevant credentials preferred.
• Ability to travel between assigned facilities as needed.
• Strong leadership, communication, and organizational skills.

Mansioni

• Provide regional oversight and support for Medicare, Managed Care and Medicaid reimbursement processes.
• Monitor reimbursement performance and identify opportunities for improvement.
• Conduct MDS audits and ensure CMS guidelines, the RAI Manual, and state/federal regulations.
• Educate and support MDS Coordinators and facility teams on PDPM, MDS coding, reimbursement regulations, and documentation best practices.
• Collaborate with facility and regional leadership to improve reimbursement outcomes.
• Assist facilities in preparing for reimbursement-related audits and regulatory surveys.
• Support corrective action plans and ongoing compliance initiatives.

Conoscenze

RN license

MDS knowledge

PDPM knowledge

Medicaid/CMI reimbursement

Leadership

Travel ability

Formazione

Active RN license

Descrizione del lavoro

Regional Reimbursement Consultant

Emerald Healthcare

Emerald Healthcare is seeking an experienced Regional Reimbursement Consultant to provide oversight, education, and support to our skilled nursing facilities. This role focuses on maximizing reimbursement accuracy, ensuring regulatory compliance, and supporting facility MDS teams.

Key Responsibilities:

• Provide regional oversight and support for Medicare, Managed Care and Medicaid reimbursement processes.
• Monitor reimbursement performance and identify opportunities for improvement.
• Conduct MDS audits and ensure compliance with current CMS guidelines, the RAI Manual, and applicable state and federal regulations.
• Provide education, training, and support to MDS Coordinators and facility teams on PDPM, MDS coding, reimbursement regulations, and documentation best practices.
• Collaborate with facility and regional leadership to improve reimbursement outcomes.
• Assist facilities in preparing for reimbursement-related audits and regulatory surveys.
• Support corrective action plans and ongoing compliance initiatives.

Qualifications:

• Active RN license.
• Strong knowledge of MDS, PDPM, and Medicaid/CMI reimbursement.
• Minimum 5 years of MDS/reimbursement experience.
• Regional or multi-facility experience preferred.
• RAC-CT certification or other relevant MDS/reimbursement credentials preferred.
• Ability to work independently while supporting multiple facilities.
• Strong leadership, communication, and organizational skills.
• Ability to travel between assigned facilities as needed.

Join Emerald Healthcare!

We offer competitive compensation, a supportive team environment, and the opportunity to make a meaningful impact across our communities.