Mds Rn Jobs

About The Position

Requirements

• Associate's Degree in Nursing required; Bachelor's Degree in Nursing preferred.
• At least 2 years of long-term care experience required; 4 years preferred.
• Current unrestricted New York State Registered Nurse (RN) license required.
• Experience with MDS, PDPM, reimbursement, and quality measures.
• Strong understanding of Medicare, Medicaid, Managed Care, and third-party payer requirements.
• Excellent time management, organizational, and problem-solving skills.
• Proven leadership skills and ability to mentor and support team members.
• Strong communication and interpersonal abilities.
• Ability to manage multiple priorities and meet deadlines.
• In-depth knowledge of long-term care regulations, reimbursement methodologies, and standards of care.
• Ability to provide education, training, and support to interdisciplinary teams.

Nice To Haves

• Bachelor's Degree in Nursing.
• Four years of long-term care experience.

Responsibilities

• Provide facility staff education and support on Medicare, Medicaid, Managed Care, eligibility, certification, coverage, documentation, utilization, and reimbursement.
• Assist facilities with certification procedures, reimbursement processes, and resolution of problem areas.
• Collaborate with claims review units, compliance teams, and third-party payers to ensure regulatory and company compliance.
• Assist with reviewing and preparing denied claims, audits, and administrative record reviews.
• Assess compliance with Medicare, Medicaid, Managed Care, and third-party payer requirements and develop corrective action plans as needed.
• Maintain and analyze reimbursement-related statistical data and utilization trends.
• Monitor authorizations and compliance with third-party payer requirements.
• Provide ongoing education and training on reimbursement programs and regulatory changes.
• Conduct PDPM reviews upon admission, re-admission, or as indicated.
• Review Medicare Part A MDS assessments for accuracy and compliance.
• Supervise MDS LPN activities and co-sign MDS assessments completed by LPN staff as required.
• Gather documentation for CMS audits and other reimbursement-related audits.
• Review physician documentation and assist with accurate ICD-10 coding and diagnosis ranking.
• Conduct MDS integrity reviews and complete MDS assessments as needed.
• Perform additional duties as assigned.

Benefits

• Paid Time Off (PTO) for full-time and part-time employees.
• Weekly or same-day pay options.
• Health insurance.
• Dental insurance.
• Vision insurance.
• Life insurance.
• Employee referral bonus program.