What are the responsibilities and job description for the MDS LPN position at Susquehanna Nursing and Rehabilitation Center?
JOB SUMMARY:
Under the supervision of a Registered Nurse, the MDS LPN coordinates Medicare, Managed Care and Medicaid
activities at the facility. Educates Administrator and facility staff on innovative procedures to maximize utilization
and reimbursement through the completion of the MDS, care plan and care guide process.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Provides education and assistance to facilities on Medicare/Medicaid related areas including eligibility,
certification procedures and follow-up of problem areas.
- Interacts with Medicare, Managed Care and Medicaid claims review unit and compliance unit to assist a
to administration on issues and activities. Interacts with the Medicare and managed Care intermediares
in areas of coverage and documentation. Assists in review and preparation of denied claims or
administrative record reviews by outside intermediaries.
- Completes compliance with Medicare, Managed Care, Medicaid and third party payers and company
Participates with any outside reimbursement audits to acquire first-hand knowledge of areas that might
lead to system failures.
- Establishes and maintains current statistical data associated with the Medicare, Managed Care and
i.e. therapies, utilization review. Reviews and maintains Medicare, Managed Care and Medicaid
reference materials.
- Monitors and identifies utilization issues. Establishes systems and programs to maximize utilization and
payment and provision of services.
- Provides ongoing orientation and training to appropriate facility staff regarding the Medicare, Managed
reimbursement program.
- PDPM reviews upon admission or re-admission or as indicated
- Review of MDS completion for Medicare A MDS’ for compliance and accuracy
- Gathers documentation for CMS audit requests and other audits as indicated
- Reviews physician documentation for accurate ICD 10 coding, assisting to set and rank diagnosis for new
- MDS Integrity reviews as indicated.
- MDS completion as needed
- Other duties as assigned
- Demonstrates experience in reimbursement, PDPM and quality measures as associated with the
- Demonstrates excellent time management and organization skills
- Proven ability to lead and inspire teams, fostering a culture of excellence and continuous
- Excellent communication, interpersonal and problem-solving skills
- Ability to effectively manage multiple priorities and meet deadlines
- In-depth knowledge of regulatory requirements and standards of care in long-term care settings.
QUALIFICATIONS:
Education: Minimum: Graduate of a LPN Vocational program
Preferred: Bachelor’s degree in Nursing
Experience: Minimum: 2 years of Long-Term Care Experience
Preferred: 4 years of long-term care experience
Licensure: NYS Licensed Practical Nurse (LPN) current, unrestricted licensure
Certification: RAC-CT certification preferred
PAY RATE: $29 - $30 per hour, dependent upon experience
Licenses & Certifications
Required- LPN
- Resident Assess Coor
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
Salary : $29 - $30