Job: CLINICAL REIMBURSEMENT COORDINATOR (RN)

Linda Manor Extended Care
345 Haydenville Road
LEEDS, MA 01053

Phone:(413)586-7700
Website:lindamanor.org

Job Title:
CLINICAL REIMBURSEMENT COORDINATOR (RN)
Salary Range:Location:
LEEDS, MA
Job Type:Category:
Full TimeHealthcare/Healthcare Professional
Education Level:Work Experience:
Associate Degree
Description:

Come join this collaborative and innovated team. At Integritus Healthcare you will enjoy generous time off, exceptional health insurance and the ability to grow in your career.

Sign-on Bonus - $5,000

Linda Manor Extended Care offers high-quality short-term rehabilitation, compassionate long-term care, and specialized dementia care for when care needs progress beyond assisted living.

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.