Bridge Care Suites is Hiring a MDS/Care Plan Coordinator Part time Near Springfield, IL
PRIMARY DUTY The overall purpose of the MDS/Care Plan Coordinator is to manage the integrity of the Facility Medicare/Medicaid Programs. This includes, but is not limited to: verification of eligibility, entitlement and coverage; completion of MDS/PPS and OBRA assessments; accurate and timely submission of all supporting documentation, as well as submission of reports timely to corporate for billing. ESSENTIAL JOB FUNCTIONS include the following. Other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Conducts pre-admission nursing screenings as assigned; ensures Medicare Part A eligibility, entitlement and coverage criteria on all new facility admissions
Obtains Medicare qualifying diagnosis for residents obtaining Medicare A services and updates diagnosis for each change in diagnosis
Prepares, coordinates and maintains schedule of MDS and resident care plans for timely completion
Initiates interim care plan on all admissions/readmissions
Monitors residents for change in condition through facility meetings and ongoing interaction with staff regarding resident's status
Ensures that resident care plans are updated as needed or indicated
Coordinates weekly Medicare meetings for interdisciplinary team and family care plan conferences
Assures preparation of Medicare denial letters for each resident discharged from Medicare coverage within time limits imposed by Medicare guidelines
Coordinates the distribution of care plan conference invitations to residents and families
Ensures electronic submission of MDS materials to the state regulatory agencies as directed
Utilizes the web based electronic computer programs to monitor the Medicare/Medicaid programs within the facility
Conducts in-service education programs regarding the MDS/Care Plan processes as assigned
Tracks daily eligibility of residents for continued Medicare benefits
Meets with therapists to report resident progress for those residents receiving direct therapy services under Part A or B Medicare services
Responsible for oversight and evaluation of consistency of documentation, care plans, physician orders, etc. to ensure accurate reimbursement
Ensures appropriate, accurate and timely completion of the physician certification/recertification form, SNF determination, and admission letter, SNF determination of continued stay, consent form (non-certified bed letter), beneficiary voluntary placement letter and Medicare secondary payer letter
Maintains back up documentation folders for Medicaid program
Monitors the facility Quality Indicator Report and submits this report to appropriate personnel as directed
Monitors the appropriate MDS website for up to date changes in the instructional manual monthly and distributes changes in the instructional manual monthly and distributes changes to the interdisciplinary team as needed
Understands and reviews the facility's Healthcare Clinical Policies and Procedures and Safety Guidelines
Reports any issues or problems that may arise to the Director of Nursing and/or Administrator
Complies with state, federal, and all other applicable health care and safety standards
Performs other duties as directed
EDUCATION and EXPERIENCE an equivalent combination of education, training and experience will be considered.
Graduate from an accredited nursing program; minimum of 2 years of previous long-term care experience; or an equivalent combination of education and experience
Must be licensed in the applicable state as a Licensed Practical Nurse (LPN) or Registered Nurse (RN); Registered Nurse (RN) preferred
Knowledge of RAI, Medicare and PPS processes required