Overview
Join our dynamic healthcare team as an MDS Coordinator / Registered Nurse (RN), where you will play a vital role in ensuring the highest standards of patient care and regulatory compliance. This position offers an exciting opportunity to utilize your clinical expertise, critical thinking, and management skills to coordinate comprehensive assessments and streamline documentation processes. As an integral part of our facility, you will lead efforts in clinical documentation improvement, utilization review, and case management to optimize patient outcomes and facility performance. We are committed to fostering a supportive environment that values your professional growth and dedication to quality care.
Responsibilities
- Conduct thorough assessments of residents’ clinical data to accurately complete the Minimum Data Set (MDS) and ensure compliance with federal and state regulations, including NCQA standards.
- Collaborate with interdisciplinary teams to develop individualized care plans aligned with patient needs, utilizing your knowledge of physiology, anatomy, and medical terminology.
- Review medical records, documentation, and coding (ICD-10, CPT) for accuracy and completeness; ensure proper medical documentation supporting billing and reimbursement processes such as DRG assignments.
- Lead utilization management activities by reviewing hospital and outpatient records, coordinating discharge planning, hospice care, or emergency medicine interventions as needed.
- Utilize electronic health record (EHR) systems such as Epic, Matrix, to document assessments, track progress notes, and generate reports efficiently.
- Monitor compliance with HIPAA regulations and maintain confidentiality of all patient information while managing medical records across inpatient, outpatient, home care, or nursing home settings.
Skills
- Extensive experience with EMR/EHR systems
- Strong knowledge of managed care policies, Medicare regulations, HIPAA compliance, and healthcare reimbursement methodologies.
- Skilled Nursing Experience
- Proven ability to perform detailed documentation review while maintaining high accuracy in medical records management across diverse healthcare environments—hospital, outpatient clinics, or nursing homes.
- Ability to navigate complex EMR/EHR platforms like Matrix and Epic efficiently; experience with health information management tools is a plus.
- Strong organizational skills with the ability to manage multiple priorities while ensuring compliance and regulatory requirements. Join us in making a difference through meticulous clinical documentation and compassionate patient care! This role offers a rewarding environment where your expertise directly impacts patient outcomes and operational excellence.
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Experience:
Work Location: In person
