Geer Village Senior Community is a non-profit organization and a community of seniors that live and receive care on our campus. Our residents, caregivers, families, staff, neighbors, volunteers and friends rely on us to provide the highest quality of care every single day.
MDS Coordinator is responsible for coordinating the care of residents admitted at a skilled level of care under the Medicare A or other insurance benefit from preadmission until discharge and/or when the resident no longer qualifies for Medicare A or private insurance benefits. Responsible for diagnosis coding and submission of MDS assessments for all residents in the facility. Works with the business office to assure accurate coding for billing according to each resident's needs.
Essential Functions:
- Reviews residents' medical record information prior to admission to determine eligibility for skilled care under the Medicare A benefit. Notifies the beneficiary or responsible party of denial of coverage prior to admission. Reviews the status of Medicare covered residents for continued coverage under the Med A benefit. Notifies the beneficiary or responsible party of denial of coverage at least 2 days prior to the end of their skilled stay . Prepares written notices in CMS approved format.
- Attends the weekly Medicare/Rehab meeting. Prepares Medicare Certification forms for physician signature
- Obtains prior authorizations from private insurers and provides updates as needed through the end of coverage
- Schedules PPS and private insurer paid MDS assessments and notifies interdisciplinary team members when they are due. Coordinates with the Rehab manager when setting ARDs to ensure that the RUG level will best represent the level of care the resident requires.
- Interviews residents and completes the MDS, CAAs and facility specific assessments when indicated in accordance with CMS guidelines and facility policies and procedures. Encourages resident/responsible party to actively participate in the care planning process.
- In conjunction with the interdisciplinary team, coordinates a written comprehensive care plan for each resident that identifies the needs/preferences of the resident, indicates the care to be given and disciplines responsible and lists measurable goals to be accomplished within specific timeframes. Communicates information to caregivers.
- Responsible for IDC coding for all residents. Enters codes in Pathlinks for all new residents and updates as often as needed. Reviews monthly claims for accurate ICD coding.
- Responsible for submission of all MDS assessments in accordance with CMS regulations. Prints copies of the QI/QM reports for the DON and Administrator . Acts as a resource person for all members of the interdisciplinary team with questions about MDS assessment and Pathlinks navigation issues
- Reviews medical records that have been selected for audits by Medicare or private insurance carriers to ensure that all pertinent information is sent.
- Reviews RUG levels with the Business office and Rehab manager for accuracy monthly prior to billing
Requirements:
Education: Must possess a nursing degree from an accredited college, university or school of nursing
Experience: 3 years MDS / Clinical Reimbursement experience in long term care preferred
Certification/License: Current unencumbered RN license in accordance with the laws of the State of CT; CPR certification
Benefits:
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Work Location: In person
