Job Description

CLINICAL REIMBURSEMENT COORDINATOR- LPN or RN

Essential Job Functions:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
-    Perform independent and/or suggested affiliate level, clinical and financial audits as warranted.
-    Identify and assist with educational opportunities through audit, tracking, trending, and analyzing relevant patient data with supervisor guidance and support.
-    Strategic planning related to ARDs; optimizing the appropriate revenue systems.
-    Ensure IDT compliance with state/federal requirements and timeframes related to MDS, billing and care planning.
-    Interpretation of revenue related data as requested.
-    Identify revenue related risks associated with missing, irrelevant, erroneous clinical documentation. Assist with action plans related to such risk as warranted.
-    Assist with orientation and education for CRCs and other IDT members as relates to MDS and/or reimbursement processes.
-    Provide ongoing education and communication with IDT as relates to current state and federal regulation systems driven by the MDS.
-    Review clinical charts and assist with determination of ongoing skilled need, and appropriate Length of Stay.
-    Under the coordination of a Registered Nurse, complete sections of the MDS.
-    Review, revise and communicate the need for new care plans as per facility protocol.
-    Attend CP meetings per facility protocol.
-    Conduct/attend as necessary the daily, weekly, monthly meetings related to Revenue. (Daily REV, Wkly MRA/CMI, Monthly Triple check)
-    Ensure/assist with the timeliness of managed care updates.
-    Assist with maintenance, risk and education related to 5 STAR Quality Measures/Value Based Purchasing, and Quality Reporting programs.
-    Provide information as requested for Additional Documentation Request (ADR) and appeals as appropriate.
-    Other related duties as assigned.

Annual Salary:
LPN - $70,000-$80,000
RN - $85,000-$95,000

Qualifications

Experience Preferred
3 years:
Reimbursement or similar experience in the LTC industry

Licenses & Certifications Preferred
REGISTERED NURSE
License Practical Nurse

How To Apply

https://recruiting.ultipro.com/BER1002BHCS/JobBoard/b0f30e3a-1861-4b21-9a14-4b6d83503ef5/OpportunityDetail?opportunityId=07eef8ca-0c99-49dc-99c1-a3094b4dc7a6