Canterbury Nursing and Rehabilitation Center is seeking qualified Registered Nurses ( RN) or Licensed Practical Nurses ( LPN) to provide dedicated, compassionate service to the residents in our skilled nursing care / rehabilitation center in the role of Clinical Reimbursement Specialist ( MDS Nurse). This is a part time position with possible full time hours soon becoming available.
· Under the direction of the Clinical Reimbursement Coordinator ( CRC, MDS RN) responsible for the coordination of the Resident Assessment Instrument ( RAI) process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payor program requirements.
· Ensures assessments accurately reflect the physical, mental and psychosocial status of each resident; ensures accuracy of RAI to reflect optimal reimbursement for services provided; ensures appropriate documentation to report and support services provided and assessment accuracy.
· Communicates effectively with other members of the interdisciplinary team.
· Follows all Extendicare policies and procedures.
A: RAI Process
· Works in collaboration with the Facility Rehab Coordinator to ensure the most appropriate assessment reference date ( ARD) is utilized for Medicare Assessments through the use of the PPS Pathway.
· Initiates, directs and maintains the Medicare PPS/OBRA Assessment schedules to ensure timely completion of all assessments.
· Collaborates with the interdisciplinary team to set appropriate ARD for all assessments.
· Ensures all new admissions have an MDS completed
· Ensures each quarterly MDS is accurate, complete and timely.
· Ensures each annual assessment is accurate, complete and timely.
· Collaborates with interdisciplinary team to identify significant change in status and implementation of Significant Change in Status MDS.
· Initiates and completes Discharge and Re-entry tracking forms accurately and timely.
· Performs Modifications/In-activations of assessment in accordance with the CMS Correction Policy.
· Verifies timely transmission of MDS Assessments, including tracking forms, to the State in accordance with EHSI standards.
· Maintains a current knowledge base regarding State and Federal Regulations, PPS and the RAI Process.
B: Case Management
· Reviews medical records, care plans, charting to ensure documentation supports care provided and reimbursement level.
· Participates in Quad check prior to release of claims.
· Reviews State MDS validation reports to identify issues and/or processes to ensure accuracy of submitted MDS’s.
· Complies with laws and regulations applicable to position and acts in accordance with Extendicare’s Corporate Compliance Program.
· Possesses a current license to practice in the State as an RN or LPN
· Working knowledge of the MDS and RAI process
· Strong interest in Medicare, Medicaid, and other payor reimbursement systems
· Able to relate positively, effectively, and appropriately with residents/patients, families, community members, volunteers and other facility staff.
· Able to read, write, speak and understand English.
· Ability to apply basic mathematical skills
· Basic computer skill.
· Strong written and verbal communication skills
We offer an attractive compensation and industry-leading benefits package including:
· Medical, dental and vision insurance
· 401 ( k) and matching contributions
· STD/LTD and life insurance
· Paid time off - personal, sick, vacation and holiday
· Employee-assistance program - employees and dependents
For full time nurses, we offer medical benefits with no premium cost during your introductory period.
We strive to provide our employees with the tools necessary for development and success.
Extendicare, helping people live better!
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