What are the responsibilities and job description for the Regional Clinical Reimbursement Specialist position at Alliance Health & Human Services?
Alliance Health Management Services is looking for an experienced clinical reimbursement specialist to join our regional team. In this role you will support our 8 facilities with any and all clinical reimbursement needs. Including :
Review the current AHMS Clinical Reimbursement (CR) Policies and Procedures for respective area, recommend modifications.
- Determine compliance with established policy. Develop and utilize a facility reporting process to ensure facility compliance with established policies. This includes both remote monitoring and onsite audits.
- Evaluate current clinical reimbursement documentation forms and assessments to ensure facilities capture the care provided and maximize reimbursement.
- Provide CR transition training to the organization to ensure that trainees gain functional knowledge, and the organization is prepared for the transition.
Serve as a resource to CR staff for problem solving and real time education as needed for respective area.
Ensure that all submissions are accurate, timely, and fully compliant with current rules and regulations.
Review and assist in all ARD requests from third party payers.
Conduct onsite audits and reviews of entire CR process. Conduct exit review with facility staff with findings and clear objectives.
Review and audit PASRR / NOMNC submissions.
Assist facilities with QM ratings objectives.
We are a not-for-profit organization and we welcome your experience, skills, and professionalism as we improve the lives or our ressidents.
Benefits :Requirements : 2 Years expereince
Bachelor Degree Required
RN License Required