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