RN MDS & Reimbursement Coordinator

Genesis HealthCare; Virginia; On-site; USD 49,000 - 70,000; Full time

Benefits offered by this job

Tuition assistance

Health, dental, vision

401K

Paid time off

Life insurance

Employee assistance program

Job summary

Genesis HealthCare is seeking a Clinical Reimbursement Coordinator, RN for The Westwood Center in Virginia. The role focuses on managing Medicare/Medicaid case-mix documentation to ensure accurate reimbursement for services provided in long-term care settings.

The MDS Nurse ensures timely MDS submissions, reviews for appropriate RUGs, and communicates case-mix data to the Business Office. BLS/CPR certification is required along with nursing licensure.

Qualifications

• Must be a graduate of an accredited School of Nursing with current RN licensure in the state of employment.
• One year of long term care clinical nursing experience is required.
• Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable.
• Must maintain current BLS/CPR certification (excluding ALFs/ILFs).

Responsibilities

• Maintain an accurate schedule of all MDS assessments and ensure timely submission of MDS assessments including case-mix, OBRA and OSRA required assessments.
• Perform concurrent MDS review to ensure appropriate RUGs category is achieved through capture of clinical information and identify opportunities to enhance reimbursement.
• Communicate case-mix data required for billing to the Business Office such as RUGs categories, modifiers, state case-mix scores, etc.
• Serve as the nursing center resource for MDS/RUGs and state case-mix systems, providing staff case-mix education and instruction on MDS terminology and format.

Education

RN licensure

Job description

Genesis HealthCare is seeking a Clinical Reimbursement Coordinator, RN for The Westwood Center in Virginia. The role focuses on managing Medicare/Medicaid case-mix documentation to ensure accurate reimbursement for services provided in long-term care settings.

The MDS Nurse ensures timely MDS submissions, reviews for appropriate RUGs, and communicates case-mix data to the Business Office. BLS/CPR certification is required along with nursing licensure.