Regional Reimbursement Specialist- CT
National HealthCare Associates | Wethersfield, CT
To promote the capture of appropriate clinical reimbursement for services provided while ensuring highest level of revenue integrity with support of corporate established reimbursement initiatives.
* Optimize reimbursement and identify opportunity through tracking, trending, and analyzing relevant data with supervisor guidance.
* Strategic planning as relates to case-mix systems.
* Perform auditing activities as outlined by the Director of Clinical Reimbursement.
* Perform consistent, focused data mining throughout assigned region.
* Provide facility visits as required with timely (48*) report of findings.
* Respond promptly to facility and regional team inquiries related to MDS and reimbursement.
* Provide management level presentation materials during quarterly meetings as outlined.
* Participate in the hiring of MDS coordinators.
* Assist with orientation and education for MDS coordinators and other IDT members as relates to MDS and/or reimbursement processes.
* Provide ongoing education and communication with the facility Administrators, MDS staff, and clinical staff as relates to current state and federal regulation governing billing and reimbursement in respective region.
* Other related duties as assigned.
* Registered nurse with 3+ years reimbursement or similar experience in the LTC industry.
* Computer literacy (Word, Excel, Power Point, Outlook). Experience with current EMR software a plus.
* Evidence of effective written, verbal and technological communication.
* Demonstrates excellent organization, communication and presentation skills.
* Deadline driven, detail oriented individual with strong analytical capabilities.
* Working knowledge of state and federal regulations governing the MDS and billing processes within a nursing facility.
* Ability to communicate with and elicit support from other regionals and IDT members at the facility level.
* Ability to apply knowledge in state specific Medicaid and Medicare RUG methodologies.
* Ability to successfully train new MDS coordinators and IDT members with varying levels of experience as appropriate.
* Ability to conduct themselves with a fair, honest, consistent, and professional temperament.
* Ability to travel >50%, with possible overnight and out of state travel assignments.
* Exhibits independent and self-directed work ethic with the ability to manage multiple facilities data.
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled