About The Position

The overall purpose of the MDS Coordinator position is to ensure appropriate reimbursement of Medicare and/or Medicaid Patients through the Patient Assessment Instrument (RAI) process. Assists in the management of quality Patient care on a continuing basis in accordance with federal and state standards and as may be directed by the Administrator or Director of Nursing.

Requirements

  • A current, valid Texas nursing license is required (RN, LVN)
  • Must have an Acknowledgement of Completion Certificate through the HHSC RUG Online Training for Nursing Facilities.
  • Ability to effectively communicate, direct, and at times, delegate tasks.
  • Ability to read, write, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
  • Ability to write reports, business correspondence, nursing/Patient progress notes, and nursing procedures.
  • Ability to effectively present information and respond to questions from department heads, customers, (Patients, family members, physicians, etc.) and the public.

Nice To Haves

  • At least 2 years of LTC experience preferred.
  • Must complete the American Association of Nurse Assessment Coordinators (AANAC) RAI Certification within 1 year of employment.

Responsibilities

  • Maintains compliance with all State and Federal Medicaid and/or Medicare rules, regulations, and published interpretations.
  • Participates in the assessment of pre-admission paperwork to ensure Patient meets qualifying medical necessity determination.
  • Attends standup meetings every weekday morning.
  • Coordinates the Weekly Reimbursement Meeting with the Interdisciplinary Team Members to ensure proper Medicare and/or Medicaid reimbursement to match care delivery.
  • Audit the Clinical Record to ensure appropriate documentation for actual care delivery. Educates and trains staff on documentation guidelines.
  • Obtains Medicare qualifying diagnosis (es) on Medicare Part A Patients and updates diagnosis for each change in diagnosis.
  • Initiates and updates the physician certifications for each Medicare Part A Patient.
  • Completes all Minimum Data Set (MDS) assessments within the allotted time frame for each Medicare and/or Medicaid Patient.
  • Reviews the 24-hour Nursing report to capture possible change in condition of a Patient.
  • Prepares for all Medicaid audits.
  • Tracks Patient benefit days, validates daily census and coordinates information with Financial Manager to ensure accurate billing.
  • Achieves at least budgeted rates expectation.
  • Has reviewed Cantex Continuing Care Network Continuing Care Network Clinical Policies and Procedures for Abuse Prevention and knows the employees responsibility to enforce it.
  • Supports and upholds the Patient Care Management Systems as well as the Financial Management Systems.
  • Responsible for assuring patient/resident safety.
  • Performs other duties and/or tasks as assigned.

Benefits

  • We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.

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What This Job Offers

Job Type

Full-time

Industry

Nursing and Residential Care Facilities

Education Level

No Education Listed

Number of Employees

1,001-5,000 employees

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