Medical Reimbursement Specialist

Rochester Manor strives to deliver exceptional patient care and services through a collaborative work environment.

About the Role

The MDS Nurse - RN oversees Medicare/Medicaid case-mix documentation to ensure accurate reimbursement for nursing services, facilitating optimal resource utilization and enhanced patient outcomes.

• Maintains schedules for MDS assessments with accurate reference dates throughout patient stays, ensuring seamless clinical operations.
• Ensures timely submission of MDS assessments, including case-mix, OBRA, and OSRA required assessments, supporting efficient billing processes.
• Conducts concurrent MDS reviews to achieve optimal RUGs categories by capturing relevant clinical information and identifying opportunities for improved reimbursement.
• Communicates case-mix data for billing purposes to the Business Office, fostering effective collaboration across departments.

Qualifications

To be successful in this role, you will need:

• A degree from an accredited School of Nursing and current RN licensure in the state where employment occurs.
• At least one year of long-term care clinical nursing experience, with a strong foundation in Medicare/Medicaid reimbursement principles.
• Experience with MDS completion, clinical resource utilization, and/or case management is highly desirable, enabling you to make informed decisions that drive quality care.
• Current BLS/CPR certification (excluding ALFs/ILFs), demonstrating a commitment to patient safety and well-being.

Benefits

We offer a competitive compensation package, including:

• Variable compensation plans, recognizing your contributions to the organization's success.
• Tuition, Travel, and Wireless Service Discounts, providing support for your personal and professional growth.
• An Employee Assistance Program to support mental health, promoting a healthy work-life balance.
• An Employee Foundation to provide financial assistance during unforeseen hardships, offering a sense of security and stability.
• A diverse, Equitable, and Inclusive workplace with a dedicated DEI committee, valuing diversity and promoting inclusivity.

Compensation Information

This role offers a salary range of USD $45.00 - USD $51.00 per hour, reflecting our commitment to fair compensation and career development opportunities.

Salary : $45 - $51