Registered Nurse Assessment Coordinator (RNAC)

Carepavilionhealth; Philadelphia (Philadelphia County); On-site; USD 65,000 - 90,000; Full time

Job summary

Carepavilionhealth is seeking an RAI Coordinator to oversee OBRA and Medicare MDS assessments, ensuring timely completion and accurate documentation across residents. This role integrates nursing, dietitian, therapeutic recreation, restorative, rehabilitation, and physicians to capture all clinical conditions and services.

The coordinator will manage electronic submissions, corrections, and records, schedule regular PPS and review meetings, and support care planning with thorough MDS analysis

Qualifications

• Experience coordinating MDS assessments (OBRA/Medicare PPS).
• Strong understanding of federal/state guidelines for healthcare documentation.
• Ability to manage timelines and regulatory reference dates.

Responsibilities

• Oversee and track MDS assessments across residents to ensure accuracy and timeliness.
• Coordinate interdisciplinary input (nursing, dietitian, therapy, rehab, physicians) for MDS completion.
• Ensure electronic submission of MDS and perform necessary corrections and recordkeeping.
• Schedule and lead PPS, Medicare/Insurance, and Clinical Review meetings.
• Assist care planning by ensuring MDS data supports CAAs and care conferences.

Skills

MDS coordination

Regulatory compliance

Interdisciplinary collaboration

Documentation accuracy

Electronic submissions

Job description

The RAI Coordinator is responsible for the timely completion of all OBRA and Medicare assessments to comply with federal regulations. Oversees the overall process and tracking of Prospective Payment System (PPS) Minimum Data Set (MDS) assessments including completion, submission and correction as needed. Integrates nursing, dietitian, therapeutic recreation, restorative, rehabilitation, and physician services to ensure accurate assessments which capture all clinical conditions and provided services.

• Confirms payer source of all residents per HIQA.
• Ensures the accurate and timely completion of all MDS Assessments including OBRA and Medicare PPS.
• Maintains an accurate schedule of all MDS assessments to include the proper reference dates throughout the resident’s stay.
• Responsible for electronic submission of all MDS assessments. Verifies electronic submission of MDS and performs corrections when necessary and maintains appropriate records.
• Coordinates interdisciplinary participation in completing the MDS for each resident according to regulatory time frames.Ensures completeness of MDS and thoroughness of documentation as mandated by federal and state standards.
• Schedules resident care conferences in compliance with state and federal regulations and ensures completion of all MDS reviews prior to resident care conference.
• Assists disciplines with care planning process by ensuring the MDS information is completed timely, the Care Area Assessments (CAAs) are analyzed thoroughly, and the team has completed the MDS prior to care conference.
• Ensures all Medicare documentation follows federal and state guidelines and is completed timely. This includes the physician certification/Recertification, Traditional Medicare and Medicare Advantage non-coverage letters for part A and B.
• Monitors activities of daily living for accuracy and provides education when warranted.
• Conducts daily PPS meeting, weekly Medicare/Insurance and Quarterly Clinical Review meetings.
• Coordinates the monthly billing process including the triple check meeting, the attested billing report, and the HMO log.
• Assists with the appeal process to insure that timelines are met and appeals submitted.
• Coordinates managed care process including submitting timely updates and obtaining ongoing authorizations.
• Ensures the timely completion of Medicaid Picture Date submissions.