Clinical Reimbursement Coordinator - Vetter Health Services

Job Description

Vetter Health Services, a premier provider of long-term care, assisted living, independent living, home health, hospice and pharmacy, is offering an opportunity for a passionate and analytical leader to join an excellent organization as a Clinical Reimbursement Coordinator. Vetter Health Services is an innovative, respected company that has been serving seniors for over 49 years. Our mission of "Dignity in Life" and our vision and values separates us from our competitors. Our national reputation in long-term care is "quality"!

The Clinical Reimbursement Coordinator is an essential part of our team who is committed to excellence in every aspect of resident care, from diagnosis to treatment and beyond

Responsibilities will include, but not be limited to,

• Overseeing multiple MDS coordinators with resident assessments to determine health status, level of care and subsequent changes.
• Conduct education on MDS policy and procedures, RAI process, quality measures, and survey support.
• Review, monitor and audit MDS data in accordance with state / federal requirements.
• Assist with development, implementation, and ongoing education of programs that apply to the RAI, PPS, QM, Medicaid case mix and Medicare / Medicaid guidelines.
• Provide consultation and facilitation for the development of maximizing clinical competence and reimbursement accuracy for the MDS systems.
• Identify areas of concern and assist facilities with the formulation of effective action plans to ensure accurate MDS coding.
• Report growth and changes as it relates to payor types for improved outcomes.
• Oversee the overall process and tracking of MDS / PPD documentation and submission.
• Interpret MDS data related to reimbursement and quality trends and provide actions to drive performance improvement.
• Analyze accuracy of MDS coding :
• Assess coding accuracy, development systems to improve accuracy and standardize systems when possible.
• Identify any coding errors or patterns that could lead to changes in quality measures, reimbursement, and / or compliance with regulatory requirements.
• Ensure continual improvement and accuracy to include developing ongoing competency tests / audits in this area.

Qualified candidates will be an RN or BSN with five years experience working with Medicare and MDS's. Clinical Reimbursement Coordinators have an excellent background in Medicaid and Medicare rules and MDS functions, a good working knowledge of nursing home regulations, and have proven training experience. Clinical Reimbursement Coordinators possess a solid knowledge base of geriatric health care and sound judgmental and technical skills, are able to schedule work according to deadlines and manage several projects simultaneously and are able to communicate effectively, both verbally and in writing, with other personnel, professional and business persons, and the general public.

Vetter Health Services offers excellent benefits, an exceptional work environment and the opportunity to learn and grow. Qualified individuals may send resumes to or

Chief People Officer

Vetter Health Services

20220 Harney Street

Elkhorn, NE 68022

Requirements