What are the responsibilities and job description for the CLINICAL REIMBURSEMENT COORDINATOR-RN position at DANVERS MANAGEMENT SYSTEMS INC?
Job Description
Job Description
From short term rehab and recovery to long term skilled nursing care, hospice services, restorative care, and even respite care, we are by your side. Hunt has been caring for families on Boston’s north shore since 1976, providing top-quality skilled nursing care in Danvers, MA for short-term rehabilitation and long-term care. We focus on maximizing patient recovery, comfort, and independence for the highest possible quality of life. From post-surgery and post-hospital rehabilitation to long-term care for a chronic illness, our highly skilled nursing care teams provide compassionate attention and specialized care every step of the way to reduce hospital readmissions and achieve exceptional outcomes.
Come join this collaborative and innovated team. At Integritus Healthcare you will enjoy weekly pat, generous time off, exceptional health insurance and the ability to grow in your career.
Clinical Reimbursement Coordinator - RN Required!
Job Duties :
- 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 as relates to ARDs to optimize appropriate revenue systems.
- Ensure IDT compliance with state / federal requirements and timeframes related to MDS, billing and care planning.
- Provide high level 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.
- 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 to determine skilled need and assist with determining appropriate Length of Stay.
- Attest to completion of MDS at section Z. Sign MDS completion for any LPNs in the department.
- Develop and revise care plans as per facility protocol. Attend / Lead CP meetings per facility protocol.
- Conduct daily, weekly, monthly meetings related to Revenue. (Daily REV, Wkly MRA / CMI, Monthly Triple check)
- Ensure 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).
- Other related duties as assigned.
Qualifications :
