PhiladelphiaRecruiter
the smart solution for Philadelphia jobs

Clinical Reimbursement Coordinator (Full Time) (Morton,PA)

Company: PowerBack Rehabilitation, Exton
Location: Morton
Posted on: November 11, 2018

Job Description:

POSITION SUMMARY: Manages the overall process and tracking of all Medicare/Medicaid case-mix documents in order to assure appropriate reimbursement for services provided within the Center. Conducts concurrent MDS reviews to assure achievement of maximum allowable RUG categories. He/she will integrate information from nursing, dietary, social services, restorative, rehabilitation and physician services to ensure appropriate reimbursement. RESPONSIBILITIES/ACCOUNTABILITIES: 1. Revenue Optimization - Resource Utilization: 1.1 Tracks Medicare Customers to determine continued and appropriate Medicare eligibility and benefit period by determining skilled level of need; 1.2 Prior to admission, reviews pre-admission intake information with the External Care Coordinator or Admissions Coordinator to estimate RUG levels for Medicare Customers and to identify potential resource costs, consider formularies, and communicate findings to Administrator/care team; 1.3 Performs concurrent MDS review to insure appropriate RUGs category is achieved through the capture of appropriate clinical information. Identifies opportunities to enhance reimbursement; 1.4 Directs the interdisciplinary team process to communicate opportunities to ensure capturing of all resources; 1.5 Collaborates with Reimbursement Services to review RUG reports and identify RUG categorization. 2. MDS Schedule and Tracking: 2.1 Maintains an accurate schedule of all MDS assessments to include the proper reference dates throughout the Customer's stay and ensures the accurate and timely submission of the MDS assessments including case-mix, OBRA and OSRA required assessments; 2.2 Communicates to the Care Plan Coordinator the MDS assessment schedule to ensure timely facilitation of the care planning process. 2.3 Completes the admission and discharge tracking form and maintains tracking system for admission/re-entry/discharge; 2.4 Manage the data entry function to ensure the accuracy of the MDS and verify electronic transmissions to Genesis and the state. 3. Billing: 3.1 Coordinate with the Center Business Office, and or/Centralized Business Office when available throughout the month, to communicate case-mix data required for billing such as RUGs categories, modifiers, state case-mix scores, etc. 4. Education and Resource: 4.1 Serves as the Center resource for MDS/RUGs and state case-mix systems; 4.2 Provides case-mix education to the interdisciplinary team as appropriate; 4.3 Instructs Center staff in terminology, language, and format that is required by MDS; 4.4 Communicates with Center Administrator, interdisciplinary team and Reimbursement Services regarding any changes in case-mix regulations such as PPS and/or state specific case-mix systems; 4.5 Trains backup personnel for the Clinical Reimbursement Coordinator; 5. Other Duties 5.1 Assists in the preparation of all requests from appropriate State and/or federal regulatory agencies or agents regarding payment of services (reconsideration, denials appeals, etc.); 5.2 Maintains all reports and transmission data in a systematic format and stores in a safe, locked area; 5.3 Maintains a current and comprehensive knowledge of MDS and Medicare/ Medicaid reimbursement; 5.4 Implements all required forms, procedures and processes relative to job responsibilities; 5.5 Performs other related duties as requested. CCR1QUALIFICATIONS: SPECIFIC EDUCATIONAL/VOCATIONAL REQUIREMENTS: 1. Graduate of an accredited School of Nursing with current RN licensure in the state in which employment occurs is required. 2. One year of long term care clinical nursing experience is required. 3. Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable. 4. Experience with basic computer technology. 5. Maintains current BLS/CPR certification (excluding ALFs/ILFs). 6. This position requires that the employee is able to read, write, speak and understand the spoken English language to ensure the safety and wellbeing of our patients and visitors at the work site when responding to their medical and physical needs. Position Type: Full TimeReq ID: 265685Center Name: PowerBack Rehabilitation, Exton

Keywords: PowerBack Rehabilitation, Exton, Philadelphia , Clinical Reimbursement Coordinator (Full Time) (Morton,PA), Healthcare , Morton, Pennsylvania

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Seeking Hospitalist to join Established Practice next to Harrisburg, PA!!
Description: Hospitalist opening in Harrisburg, Pennsylvania. This and other physician jobs brought to you by DocCafe.com Seeking Hospitalist to join Established Practice next
Company: DOCTORS CHOICE PLACEMENT SERVICES, INC.
Location: Harrisburg
Posted on: 11/15/2018

Internal Medicine Physician - near Harrisburg, Pennsylvania
Description: Internal Medicine opening in Harrisburg, Pennsylvania. This and other physician jobs brought to you by DocCafe.com Internist Needed Near Harrisburg, Pennsylvania Internist needed to join practice
Company: Integrity Healthcare
Location: Harrisburg
Posted on: 11/15/2018

General Neurologist Lancaster, PA
Description: Neurology opening in Lancaster, Pennsylvania. This and other physician jobs brought
Company: Northeast Healthcare Recruitment, Inc.
Location: Lancaster
Posted on: 11/15/2018


RELOCATION OPPORTUNITY: RN - Neuro: Winston-Salem, NC
Description: Overview br Employer is seeking a Neuro RN to work with a team that fosters growth, support and optimal care to both our patients and team members. Come join a remarkable team where quality care meets (more...)
Company: Novant Health
Location: Lakewood
Posted on: 11/15/2018

Physical Therapist - Home Health - (PT - HH)
Description: General Practice opening in Hicksville, New York. This and other physical therapy jobs brought to you by AlliedHealthJobCafe.com Job Description Requirements br Physical Therapist - Home Health - (more...)
Company: Club Staffing
Location: Hicksville
Posted on: 11/15/2018

LPN
Description: LPN Limited Time Offer- 4,000 Sign On Bonus for those hired FT 3p-11p shift only Conestoga View, a long term care facility focusing on short
Company: CONESTOGA VIEW
Location: Lancaster
Posted on: 11/15/2018

NP/PA - Inpatient BMT/Medical Oncology - Harrisbur
Description: NP/PA - Inpatient BMT/Medical Oncology - Harrisburg, PACompany500 bed academic medical centerMagnet HospitalThe CommunityTop 10
Company: Brian McMahon & Associates
Location: Harrisburg
Posted on: 11/15/2018

Extended School Year Nurse
Description: MINIMUM QUALIFICATIONS: All applicants must possess a current professional PA
Company: Harrisburg School District
Location: Harrisburg
Posted on: 11/15/2018

RN SUPERVISOR
Description: RN SUPERVISOR FT 11-7 SHIFT Conestoga View, a long term care facility focusing on short term rehab and other specialized
Company: CONESTOGA VIEW
Location: Lancaster
Posted on: 11/15/2018

Pennsylvania Ob/Gyn Job with $250,000 Salary-45 Minutes to Penn State University
Description: Obstetrics Gynecology opening in Harrisburg, Pennsylvania. This and other physician jobs brought to you by DocCafe.com We are seeking an additional Obstetrics and Gynecology to join a busy,
Company: The Curare Group, Inc
Location: Harrisburg
Posted on: 11/15/2018

Log In or Create An Account

Get the latest Pennsylvania jobs by following @recnetPA on Twitter!

Philadelphia RSS job feeds