Director of Reimbursement

Vetter Senior Living • Elkhorn, NE

11h

About The Position

Vetter Senior Living is seeking a Director of Reimbursement to provide Medicare and MDS support to its senior living facilities. The role supports facilities through strong working relationships and helps advance quality long-term care while meeting reimbursement and regulatory requirements.

The Director reviews Medicare and Medicaid programs and MDS systems, ensures services are captured for reimbursement, sets utilization standards, and develops guidance and tools for managing the financial impact of admissions. The position also oversees education and training related to ADL coding, PDPM and RUG, iQIES reports, Quality Metrics, legislation changes, and timely MDS submission.

Requirements

• Ten years of work experience as an RN and five years working with Medicare and MDS.
• Excellent background in Medicaid and Medicare rules and MDS functions, and good working knowledge of nursing home regulations.
• Proven training experience and a solid knowledge base of geriatric health care.
• Sound judgment and technical skills; able to meet deadlines and manage several projects simultaneously.
• Effective verbal and written communication with personnel, professionals, business contacts, and the public.
• High personal integrity, a caring attitude, and a strong desire to relate to and work with others.

Responsibilities

• Review Medicare and Medicaid programs and MDS systems to identify strengths and opportunities for improvement.
• Ensure all services are captured for appropriate reimbursement.
• Set standards and benchmarks for Medicare Part A and B utilization to maximize reimbursement while meeting regulatory requirements.
• Review and establish guidelines and develop tools to manage the financial impact of the admission process.
• Analyze ADL coding, assess accuracy, and identify miscoding or under-coding that could contribute to lost revenue.
• Develop comprehensive ADL training for staff, along with ongoing competency tests and audits.
• Develop and maintain PDPM and RUG education, including RUG distribution, assessment reference date selection, interdisciplinary communication, and timely MDS submission to meet billing timeframes.
• Develop training programs as legislation changes and serve as a teacher, model, and consultant for other staff.
• Manage education related to iQIES reports and Quality Metrics.
• Build cooperative working relationships with other departments and uphold safety, regulatory, and company standards.

Benefits

• Health, dental, and vision insurance
• 401(k) with company match
• Paid Time Off (PTO)
• Paid holidays
• Educational Loan Reimbursement Program
• Earned wage Access
• Employee Assistance Program (EAP)
• A family-oriented culture dedicated to supporting team members and residents alike

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: No Education Listed