Integritus Healthcare ยท 1 day ago
CLINICAL REIMBURSEMENT COORDINATOR (RN/LPN)
Leeds, Massachusetts, United States
Full-time
Onsite
Mid LevelIntegritus Healthcare is seeking a Clinical Reimbursement Coordinator to join their collaborative and innovative team. The role involves performing clinical and financial audits, ensuring compliance with state and federal requirements, and providing education and support related to reimbursement processes.
Hospital & Health Care
Responsibilities
Perform independent and/or suggested affiliate level, clinical and financial audits as warranted
Identify and assist with educational opportunities through audit, tracking, trending, and analyzing relevant patient data with supervisor guidance and support
Strategic planning related to ARDs; optimizing the appropriate revenue systems
Ensure IDT compliance with state/federal requirements and timeframes related to MDS, billing and care planning
Interpretation of revenue related data as requested
Identify revenue related risks associated with missing, irrelevant, erroneous clinical documentation. Assist with action plans related to such risk as warranted
Assist with orientation and education for CRCs and other IDT members as relates to MDS and/or reimbursement processes
Provide ongoing education and communication with IDT as relates to current state and federal regulation systems driven by the MDS
Review clinical charts and assist with determination of ongoing skilled need, and appropriate Length of Stay
Under the coordination of a Registered Nurse, complete sections of the MDS
Review, revise and communicate the need for new care plans as per facility protocol
Attend CP meetings per facility protocol
Conduct/attend as necessary the daily, weekly, monthly meetings related to Revenue. (Daily REV, Wkly MRA/CMI, Monthly Triple check)
Ensure/assist with the timeliness of managed care updates
Assist with maintenance, risk and education related to 5 STAR Quality Measures/Value Based Purchasing, and Quality Reporting programs
Provide information as requested for Additional Documentation Request (ADR) and appeals as appropriate
Other related duties as assigned
Qualification
Required
Active MA Registered Nurse (RN) preferred or Active MA Licensed Practical Nurse (LPN)
Benefits
WEEKLY pay
Generous time off
Exceptional health insurance
Sign on Bonus $5,000
Competitive pay based on experience
Company
Integritus Healthcare
Integritus Healthcare (previously Berkshire Healthcare) is a midsize healthcare, senior care, and senior living company.
Founded in 1996
1001-5000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase