RN MDS & Reimbursement Specialist (Long-Term Care)

Genesiscareers; Peterborough (NH); On-site; USD 57,000 - 82,000; Full time

Benefits offered by this job

Variable pay

Education discounts

Employee assistance program

401K

Job summary

Genesiscareers is seeking a qualified MDS Nurse (RN) to oversee Medicare/Medicaid case-mix documentation and ensure proper reimbursement within a long-term care setting in New Hampshire. The role emphasizes accurate MDS scheduling, OBRA/OSRA compliance, and timely submissions.

The ideal candidate will have an accredited nursing degree and an active RN license in the posting state, plus experience with MDS processes and billing data. BLS/CPR certification is required.

Qualifications

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

Nursing experience

MDS knowledge

Medicare/Medicaid knowledge

BLS/CPR certified

Education

RN license

Tools

MDS software

Case-mix systems

Job description

Genesiscareers is seeking a qualified MDS Nurse (RN) to oversee Medicare/Medicaid case-mix documentation and ensure proper reimbursement within a long-term care setting in New Hampshire. The role emphasizes accurate MDS scheduling, OBRA/OSRA compliance, and timely submissions.

The ideal candidate will have an accredited nursing degree and an active RN license in the posting state, plus experience with MDS processes and billing data. BLS/CPR certification is required.