Registered Nurse (RN), Regional Assessment and Reimbursement Coordinator

CHQ CHSI EMP LLC; Indianapolis (IN); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive wages

PTO plans

Health/dental/vision coverage

401(k) with employer match

Flexible Spending Accounts

Job summary

CommuniCare Health Services seeks an RN Regional Assessment and Reimbursement Coordinator to drive RAC activities across Indianapolis-area centers. The role emphasizes evaluation, education, intervention, and support for the RAI process and contract reimbursement systems to ensure compliant and optimized patient care and billing.

The position requires an active RN license and at least 3 years of trainer experience in Medicare/Medicaid/RAI, with preference for multi-facility management

Qualifications

• Registered Nurse license in primary state of residence.
• Minimum of three (3) years of experience as a trainer in Medicare, Medicaid, RAI, and contract reimbursement systems preferred
• Multi-facility management experience preferred

Responsibilities

• Interpreting State and Federal regulations and changes to Medicare/Medicaid programs
• Providing comprehensive training for systems related to patient assessment instruments, clinical software, Medicare reimbursement, and Medicaid requirements
• Monitoring and supporting center reimbursement and clinical services
• Guiding implementation of the case management process and providing ongoing program integrity support
• Ensuring accuracy and completeness of the RAI process through medical record review, documentation, and reporting
• Maintaining the RAC role when needed and mentoring new RACs as required
• Establishing rapport with regional and center teams and communicating concerns appropriately

Skills

Trainer experience

Medicare & Medicaid

RAI knowledge

Contract reimbursement

Education

RN license

Job description

Job Address: 8275 Allison Pointe Trail Suite 370 Indianapolis, IN 46250 CommuniCare Health Services is currently looking to fill the key position of RN Regional Assessment and Reimbursement Coordinator in the Indianapolis, Indiana area.

PURPOSE/BELIEF STATEMENT

As the Regional Assessment and Reimbursement Coordinator, you will provide consultation, guidance, support, research, analysis, training, and expertise to attain business goals and quality outcomes in the delivery of care and services to our patients regardless of payer source. You will be responsible for multiple centers to evaluate and provide education, intervention, and support for the Resident Assessment Instrument (RAI) process, Federal and State regulations regarding reimbursement systems, and special contract reimbursement systems.

JOB RESPONSIBILITIES

• Demonstrating knowledge of and interpreting applicable policies and procedures, State and Federal regulations, and interpreting changes to federal Medicare and Medicaid programs
• Providing comprehensive training for systems related to the patient assessment instrument, clinical software, Medicare reimbursement, Medicare coverage/eligibility requirements, State Medicaid reimbursement systems, and special contract systems
• Monitoring and supporting center reimbursement and clinical services
• Providing direction for the implementation of the case management process and providing on-going support as it relates to the program integrity
• Monitoring RAI process for accuracy and completeness to assure accurate, comprehensive patient assessment and reimbursement potential is reflected by medical record review, discussion, recommendation, documentation, and reporting
• Maintaining role of RN Resident Assessment Coordinator (RAC) when needed
• Recruiting and orienting new RACs as needed
• Establishing rapport and trust with regional and center teams, communicating concerns appropriately

POSITION REQUIREMENTS

• Registered Nurse license in primary state of residence
• Minimum of three (3) years of experience as a trainer in Medicare, Medicaid, RAI, and contract reimbursement systems preferred
• Multi-facility management experience preferred

Benefits

As a CommuniCare employee you will enjoy competitive wages and PTO plans in a great team atmosphere! We offer you a menu of benefit options from life and disability plans to medical, dental and vision coverage, from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.

About Us

A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients and family members care for and about one another. Since 1984, CommuniCare Family of Companies has been committed to delivering exceptional person-centered care as a national leader in post-acute care for those that are chronically ill or have complex conditions. Our more than 150 skilled nursing, assisted living, and long-term care facilities deliver sophisticated and transformative care to nearly 16,000 residents and patients at any given time. CommuniCare employs more than 19,000 employees across six states (Ohio, Indiana, Maryland, Virginia, West Virginia and Pennsylvania). As a family owned and operated company, family and heart are woven into every aspect of our continuum of care. Our mission, to serve with pride, is evident and a quality residents, families and community partners have come to expect and trust. Dedicated to improving the lives of seniors, we put extraordinary service above all else. We continue to raise the bar and innovate wherever possible to deliver a higher quality of life for those far beyond our facilities. Because of this, our facilities are a better place for residents to live, patients to stay, employees to work and families to heal.