Balance Life & Work with a New Career Opportunity
(LONG TERM CARE)
(SHORT TERM REHAB)
(SKILLED NURSING)
(SUB ACUTE CARE)
CareOne is hiring for a Regional Clinical Reimbursement Specialist - Western MA
$140K - $155K
Compensation will be based on, but not limited to, experience, qualifications, credentials and any other relevant information
Will have responsibility for up to FOUR(4) CareOne centers
The Regional Clinical Reimbursement Specialist assures the management of the Medicare, Managed Care and Medicaid reimbursement system for a region-specific number of skilled nursing facilities. Job duties include, but are not limited to:
Implement and direct Medicare and Medicaid auditing and systems review.
Admission pre-screening review
Admission documentation requirement review
Financial documentation requirement review
Clinical documentation assessment
Strategic selection of assessment reference dates
MDS accuracy
ADL score tracking
Denials management
RUGs management
Provide Interdisciplinary Team Training
Consolidated billing
Update facilities on trends, developments, concepts and techniques in the Medicaid and Medicare fields that affect reimbursement services
Engage facility management team in problem solving process to identify improvement opportunities and achieve solution
Facilitate effective, well organized utilization meetings, establish productive objectives and follow through with action plans
Evaluate performance of facility-based staff and make recommendations regarding staff assignments, assessment procedure and reimbursement systems. Ongoing evaluation of the effectiveness of reimbursement staff
Fee Schedule
Position Requirements:
Diploma and/or Degree from credentialed school of nursing. Currently licensed as a Registered Nurse in the state of practice
Minimum of 5 years of experience in long term care
Proven knowledge of quality improvement processes with an emphasis on Medicare, Managed Care and MA Casemix for Skilled Nursing facilities
Multi facility experience with management skills
Excellent oral and written communication skills
Word processing and related computer skills
Current licensing and credentials are required
CareOne Employer Description
The CareOne mission is to define excellence within the health care community. We are dedicated to Maximizing Patient Outcomes. We treat Residents, their families and each other with respect, dignity and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our Centers and Communities. We work to maintain the highest standards of care and service for Residents, families and our valued employees.
We are proud to Offer:
If working with people who are dedicated, compassionate, and concerned about their patients is essential to you, then you'll appreciate being a part of our team. We've built a strong reputation on the outstanding level of care that we provide. We have a graciously appointed facility with strong belief in patient care and service; join us at our beautiful facility!
We are an Equal Opportunity Employer
EEO/AA/M/F/DV
