Benedictine

Clinical Reimbursement Director- Benedictine Living Community-Rochester

Job Locations USA-MN-Rochester/Byron
Posted Date 2 weeks ago(11/19/2021 9:21 AM)
Campus Name
Benedictine Living Community-Rochester
Category
Nursing Administration
Position Type
Full-Time
Shift
Days
Specific Shift Times
7a-5p
Scheduled Days of the Week
Monday - Friday
Weekend Work Requirement
Varies

Overview

The Clinical Reimbursement Manager is responsible for the coordination of the MDS and RAI process. 

Responsibilities

Maintains communication between payer, physician, family, resident, and team to capture all services delivery costs, including managed care contracts.  Analyzes services and interventions with team during course of treatment and makes necessary adjustments to improve outcomes and assure proper level of reimbursement.  Communicates with responsible party when Medicare and Medicaid coverage is no longer appropriate, and monitors resident’s chart to determine if continued coverage is needed.  Assists with ICD-9 and ICD-10 coding and sequencings.

Qualifications

Qualifications Required

  • Current state licensure as a Registered Nurse (RN), in good standing.
  • Graduation from an accredited school of professional nursing.
  • Resident Assessment Coordinator certification (RAD-CT).
  • CRP certified.
  • Knowledge of current state and federal regulations governing long-term care facilities.
  • Knowledge of RAI/MDS/Care Planning, Medicare, Private Insurers, and Medicaid processes.

Qualifications Preferred

  • RAI/MDS/Clinical Reimbursement coordination experience.
  • Geriatric nursing or health care experience.
  • MatrixCare EHR experience.

 

EEO/AA/Vet Friendly

 

 

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