RN - MDS Coordinator

Elderwood•City of Niagara Falls, NY

About The Position

Are you a Registered Nurse (RN) with Medicare experience? Do you consider yourself an expert in assessment and reimbursement methodology? We want to talk with you! The RN - MDS Coordinator Position Overview: Oversees, reviews and/or completes the MDS/PPS components of the facility based MDS/PPS departments. Completes and/or oversees completion of all Medicare PPS MDS and/or OBRA assessments for both subacute and long-term care. Establishes the schedule for completion of the Medicare required assessments setting the completion date to maximize reimbursement and RUGs categories for each individual assessment. Acts as support/liaison to the business office coordinator and/or designee in determining eligibility for Medicare and tracking Medicare days in the facility. Serves as facility contact with Managed Care providers to ensure appropriate authorization and reimbursement for facility services provided.

Requirements

Licensed Professional Nurse (RN licensure preferred) with current license in state employed
Prior experience with MDS 3.0 scheduling, coding and submission requirements preferred
Experience with PointClickCare preferred
Experience with Patient Driven Payment Model (PDPM) and Case Mix Index (CMI) preferred
Experience with state Medicaid program, Medicare/PPS program, Managed Care programs, RUGs III and RUGs IV classification and reimbursement systems, Part A coverage
Excellent verbal and written communication skills.
Self-motivated, highly organized, and dedicated
Willing to train the right candidate
This position requires regular interaction with residents, coworkers, visitors, and/or supervisors. In order to ensure a safe work environment for residents, coworkers, visitors, and/or supervisors of the Company, and to permit unfettered communication between the employee and those residents, coworkers, visitors, and supervisors, this position requires that the employee be able to read, write, speak, and understand the English language at an intermediate or more advanced level.

Responsibilities

Participates and collaborates with Medical Records and Therapy staff in preparing records for CMS and various entities for pre and post-pay record reviews, ADR requests and appeals processes.
Manages NYS RUGs III case mix for Medicaid reimbursement.
Completes occasional travel between facilities and Elderwood Learning Center.
Supervises MDS Coordinator(s), if designated.
Demonstrates knowledge and understanding of all policies and procedures and ability to reference them.
Performs other duties as assigned by supervisor, management staff or Administrator.