CommuniCare Health Services is currently looking to fill the key position of RN Regional Assessment and Reimbursement Coordinator in the Cincinnati, OH area.
PURPOSE / BELIEF STATEMENT
As the Regional Assessment and Reimbursement Coordinator, you will provide consultation, guidance, support, research, analysis, training, and expertise to attain business goals and quality outcomes in the delivery of care and services to our patients regardless of payer source.
You will be responsible for multiple centers to evaluate and provide education, intervention, and support for the Resident Assessment Instrument (RAI) process, Federal and State regulations regarding reimbursement systems, and special contract reimbursement systems.
JOB RESPONSIBILITIES
- Demonstrating knowledge of and interpreting applicable policies and procedures, State and Federal regulations, and interpreting changes to federal Medicare and Medicaid programs
- Providing comprehensive training for systems related to the patient assessment instrument, clinical software, Medicare reimbursement, Medicare coverage / eligibility requirements, State Medicaid reimbursement systems, and special contract systems
- Monitoring and supporting center reimbursement and clinical services
- Providing direction for the implementation of the case management process and providing on-going support as it relates to the program integrity
- Monitoring RAI process for accuracy and completeness to assure accurate, comprehensive patient assessment and reimbursement potential is reflected by medical record review, discussion, recommendation, documentation, and reporting
- Maintaining role of RN Resident Assessment Coordinator (RAC) when needed
- Recruiting and orienting new RACs as needed
- Establishing rapport and trust with regional and center teams, communicating concerns appropriately
POSITION REQUIREMENTS
- Registered Nurse license in primary state of residence
- Minimum of three (3) years of experience as a trainer in Medicare, Medicaid, RAI, and contract reimbursement systems preferred
- Multi-facility management experience preferred
Benefits
As a CommuniCare employee you will enjoy competitive wages and PTO plans in a great team atmosphere! We offer you a menu of benefit options from life and disability plans to medical, dental and vision coverage, from quality benefit carriers.
We also offer 401(k) with employer match and Flexible Spending Accounts.If you meet the requirements below for Mobile MDS Coordinator, and are interested in this opportunity, please respond to this ad with your letter of interest for immediate consideration.
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