RN Specialist

Bethesda Brings out the Best inTalented, Caring People!

At Bethesda,more than 1,200 employees dedicate their careers to improving thelives of others.

As a team member at Bethesda, you'llenjoy great benefits such as : 403b, daily pay, bonuses, careeradvancement opportunities, and holiday pay.

Medical,dental, vision, prescription, and life insurance available forregular status full and part timeemployees.

Summary

Responsiblefor conducting audits of the medical billing documentationsupporting claims billed to third parties, particularly Medicareand Medicaid.

These audits determine whether services provided toresidents and billed, are consistent with medical recorddocumentation and in accordance with appropriate third-partybilling regulations and / or standards.

Findings are communicated toappropriate personnel. Emphasis will be placed on MDS auditing andbest practices documentation.

Conducts internal audits of medicaldocumentation supporting claims billed to third parties and billingis done in accordance with appropriate third-partyregulations / standards.

Assists in education of clinicians andbilling staff to support compliance with third party documentationand billing standards.

Provides education to clinical staff in theproper use of EMR reports related to documentation in the MDS.Prepares written reports of the results of the audits and presentsthem to management and billing staff with recommended correctiveactions.

Responds to questions from nursing / billing staffregarding billing, coding and documentation. Works on jointprojects with other internal compliance staff to resolve billingand documentation issues.

Follows established policies andprocedures, quality assurance, safety, environmental and infectioncontrol standards. Assists with periodic clinical reviews oflong-term care communities in preparation for governmental or otheraccrediting body inspections.

Assists with periodic review ofQuality Measures and education of the interdisciplinary team.Monitors documentation patterns for accuracy of information throughthe use of reporting mechanisms within the electronic medicalrecord software.

JobQualifications

• Registerednurse, bachelor degree preferred
• Active RNlicense in Missouri and Illinois, or willing to obtain as soon aspossible
• Two years of Long-Term careexperience, with at least one year as MDS Coordinator
• Acute care highly desirable
• Knowledge of Medicare and Medicaid required
• Experience training / teaching adults preferred
• Software skills in Word, Excel, Power Point or equivalentrequired
• Basic knowledge of and experienceutilizing a personal computer
• Verbal andwritten communication skills
• Excellentinterpersonal and organizational skills
• Manualdexterity, coordination and skillful use of hands for working withrequired equipment
• Ability to receive andexpress detailed information through oral communication, visualacuity
• Ability to read and understand writtendirections

Category : RN