The SC RN-Clinical Reimbursement Coordinator Float is responsible for assigned resident’s MDS/RAI care plan implementation, completion, transmission, and auditing through the Triple Check process. The RN-Clinical Reimbursement Coordinator Float is responsible for coordination of clinical payment programs including the Quality Reporting Program, the Value Based Purchasing program and when applicable, community participation in incentive payment program initiatives. Responsible for case mix review in determining reimbursement case mix levels. Effectively interacts with residents, family members and other health team members, while maintaining standards of professional nursing to assure resident safety. Provides MDS scheduling back up to the Clinical Reimbursement Manager, when applicable.

• Participate in interdisciplinary Clinical Reimbursement meetings as delegated to gather information necessary for the development of the care plan and to ensure the insurer requirements for documentation are met.
• Prepare or assist in the preparation, implementation and scheduling of each resident’s MDS, CAA analysis and care plan.
• Assist the Rehabilitation Services, Wellness, Culinary and Social Services departments with the MDS Monitor timeliness of MDS completion and reports any outstanding departments or issues.
• Participate in internal reimbursement audit processes as assigned.
• Performs other duties, tasks and/or projects as as assigned.
• Promotes the Benedictine Mission and Core Values of Hospitality, Stewardship, Respect and Justice by bringing the Mission and Core Values into the day-to-day activities of the company.

QUALIFICATIONS REQUIRED

• Graduation from an accredited school of professional nursing
• Current applicable state RN license to practice nursing, which must be in good standing
• BLS Certified
• Experience in geriatric nursing
• MDS/RAI experience in the past 2 years
• Working knowledge of multi-state state and federal regulations governing long-term care facilities
• Experience in working with the MDS, Medicare, assessment, and care-planning processes

QUALIFICATIONS PREFERRED

• AANAC Certification RAC-CT
• CPR Certified