RN OR LPN MDS Coordinator Clinical Reimbursement Experienced

Vantage Care, LLC; New Bedford (MA); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

401(k)

Health insurance

Dental insurance

Vision insurance

Life insurance

Vacation

Holidays

Paid Sick Time

Job summary

Vantage Health & Rehab of New Bedford is seeking an experienced MDS Coordinator/Clinical Reimbursement RN/LPN to manage Medicare/Medicaid case-mix documentation and ensure proper reimbursement for services provided. This role coordinates MDS assessments, HIPPS categorization, and collaborates with facility staff to maintain accurate documentation.

Responsibilities include scheduling, concurrent MDS reviews, education on MDS terminology, and development of care plans that support both care

Qualifications

• Must be a graduate of an accredited School of Nursing with current RN/LPN licensure.
• Experience with Medicare/Medicaid reimbursement and MDS completion is highly desirable.
• Must maintain BLS/CPR certification.

Responsibilities

• Maintains the schedule of all MDS assessments and ensures timely submission of MDS, case-mix, OBRA and PDPM assessments.
• Perform concurrent MDS review to optimize HIPPS category through accurate clinical information.
• Collaborate with facility staff to ensure complete documentation supporting MDS coding and reimbursement.
• Communicate case-mix data required for billing to the Business Office (HIPPS, modifiers, state case-mix scores).
• Serve as the nursing center resource for MDS/HIPPS and state case-mix systems; provide education on MDS terminology and format.
• Develop resident-specific care plans to support quality of care and reimbursement.

Skills

RN/LPN licensure

Long term care experience

BLS/CPR certification

MDS understanding

HIPPS knowledge

case management

Medicare/Medicaid reimbursement

Education

RN or LPN degree/licensure

Tools

MDS/HIPPS systems

Job description

MDS Coordinator / Clinical Reimbursement

Located at: Vantage Health & Rehab of New Bedford

200 Hawthorn Street, New Bedford, MA 02740

Excellent Benefits

• 401(k)
• Health
• Dental insurance
• Vision
• Life insurance
• Vacation
• Holidays
• Paid Sick Time

The MDS Coordinator / Clinical Reimbursement - RN/LPN manages the overall process and tracking of all Medicare/Medicaid case-mix documents to ensure appropriate reimbursement for all services provided within the nursing.

MDS Coordinator / Clinical Reimbursement Position Highlights

• Maintains the 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 PDPM required assessments.
• Perform concurrent MDS review to ensure appropriate HIPPS category is achieved through the capture of appropriate clinical information and in this process identify opportunities to enhance reimbursement.
• Collaborate with facility staff to assist with ensuring accurate/complete documentation to support accurate coding of MDS assessments and prevent revenue recoupment on audits.
• Communicate case-mix data required for billing to the Business Office such as HIPPS categories, modifiers, state case-mix scores, etc.
• Serve as the nursing center resource for MDS/HIPPS and state case-mix systems providing staff case-mix education and instruction on MDS terminology and format.
• Ensure the development of accurate and resident specific care plans to support quality of care and reimbursement.

Requirements:

• *Must be a graduate of an accredited School of Nursing with current RN/LPN 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).

Vantage Care requires evidence of COVID-19 vaccination for all Vantage personnel and affiliates who will be present at a facility. Exemptions will be provided in accordance with applicable federal and state laws.

Vantage Care is an equal employment opportunity employer. All employment decisions are based on merit, qualifications, and competence and not influenced or affected by race, color, religion, age, gender, national origin, ancestry, marital status, military status, veterans’ status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by federal, state, or local law.