Reimbursement Nurse (RN) - Skilled Nursing

The Moorings Park Institute Incorporated•East Naples, FL

2d•Onsite

About The Position

Moorings Park Communities is seeking an experienced and detail-oriented Reimbursement Nurse to support clinical reimbursement processes and ensure accurate resident assessments, documentation, and regulatory compliance. This role works collaboratively with the interdisciplinary care team to optimize reimbursement outcomes while promoting quality resident care and adherence to federal and state requirements.

Requirements

Associate or Bachelor of Science in Nursing from an accredited nursing program required.
Active Florida Registered Nurse (RN) license required.
Current Florida CPR certification required.
Excellent verbal and written communication skills in English required.
Must be available to work during emergencies or natural disasters as operational needs require.

Nice To Haves

Strong understanding of clinical documentation, assessment processes, and reimbursement principles in post-acute or long-term care settings preferred.
Minimum six (6) months of nursing experience preferred.
Experience working with geriatric populations strongly preferred.

Responsibilities

Coordinate resident assessment activities to support reimbursement accuracy and regulatory compliance.
Review, complete, and submit clinical assessment data in accordance with Medicare, Medicaid, PDPM, and other applicable reimbursement guidelines.
Monitor documentation practices to ensure accurate clinical representation of resident conditions and services provided.
Collaborate with nursing staff, therapy departments, physicians, and ancillary team members to validate assessment findings and reimbursement opportunities.
Maintain assessment schedules and ensure timely completion of required documentation and reporting.
Participate in reimbursement and utilization review meetings to evaluate resident eligibility and coverage requirements.
Audit clinical records for completeness, accuracy, and compliance with reimbursement standards.
Educate clinical team members on documentation requirements that impact reimbursement and quality measures.
Track and communicate regulatory changes affecting reimbursement methodologies and payment systems.
Support quality improvement initiatives related to resident assessments, documentation integrity, and reimbursement performance.
Assist with regulatory surveys, audits, and requests for information as needed.
Maintain current knowledge of long-term care reimbursement systems, regulatory requirements, and industry best practices.