RN MDS & Reimbursement Specialist

Genesis HealthCare, Inc.; White Sulphur Springs (WV); On-site; USD 51,000 - 73,000; Full time

Benefits offered by this job

Health, Dental, Vision

Company-paid life insurance

401K

Paid Time Off

Employee Assistance Program

Employee Foundation

On-Demand Pay

Tuition discounts

Job summary

Genesis HealthCare, Inc. is seeking a responsible MDS Nurse -- RN to manage Medicare/Medicaid case-mix documentation and ensure proper reimbursement for services in a long-term care setting.

The role requires RN licensure in the employment state and at least one year of long-term care nursing experience, with BLS/CPR certification current. Knowledge of MDS, RUGs and state case-mix systems is highly desirable.

Qualifications

• Must be a graduate of an accredited School of Nursing with current RN licensure in the state in which employment occurs.
• 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

• The MDS Nurse -- RN manages the overall process and tracking of all Medicare/Medicaid case-mix documents to ensure appropriate reimbursement for all services provided within the nursing.
• Maintain an accurate schedule of all MDS assessments to include the proper reference dates throughout the patient stay and ensures the accurate and timely submission of the MDS assessments including case-mix, OBRA and OSRA required assessments.
• Perform concurrent MDS review to insure appropriate RUGs category is achieved through the capture of appropriate clinical information and in this process 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.

Skills

RN licensure

Long-term care experience

Medicare/Medicaid knowledge

MDS knowledge

Education

Nursing degree (RN) or equivalent

Job description

Genesis HealthCare, Inc. is seeking a responsible MDS Nurse -- RN to manage Medicare/Medicaid case-mix documentation and ensure proper reimbursement for services in a long-term care setting.

The role requires RN licensure in the employment state and at least one year of long-term care nursing experience, with BLS/CPR certification current. Knowledge of MDS, RUGs and state case-mix systems is highly desirable.