RM Management · 12 hours ago
Elderly Waiver Reimbursement Specialist
Golden Valley, MN
Full-time
Onsite
Entry, Mid Level
$70K/yr - $80K/yr
2+ years expRM Management is seeking an Elderly Waiver Reimbursement Specialist responsible for managing reimbursement processes for residents receiving services through Minnesota waivers. The role involves ensuring compliance and accuracy in reimbursements, collaborating with various departments, and staying updated on relevant policies and regulations.
Elder CareHealth CareWellness
Responsibilities
Manages reimbursement for services provided to residents utilizing EW/CADI in assisted living settings, in collaboration with Director of Elderly Waiver, MA Specialist, Billing Specialist, Clinical, Operations and Admissions
Confirms eligibility prior to admission - MN-ITS verifications
Completes 6790/Customized Living tools utilizing clinical documentation as well as face to face interactions. Ensures documentation supports authorized services
Direct communication with clinical in each community to be updated on changes to services and leave of absences
Monitor support plans, service authorizations, rate changes, and renewals
Audit EMR to ensure changes of conditions are being accurately reported and updated 6790 submitted as appropriate
Educate clinical and administrative staff on documentation best practices impacting reimbursement
Identify reimbursement risks and proactively recommend corrective actions
Stay current with Minnesota DHS waiver policies, rate frameworks, and regulatory changes
Work onsite with residents and staff through all facilities in metro area
Qualification
Required
2+ years of experience with Elderly Waiver reimbursement or care coordination
Experience working in assisted living, home care, or long-term care settings
Excellent attention to detail and strong organizational skills
Ability to work collaboratively with clinical, financial, and county partners
Preferred
Established relationships with county case managers and state billing entities
Experience with Eldermark or similar EHR and Medicaid billing systems
Experience with CADI or BI waivers
Prior reimbursement, MDS, or utilization review experience
Bachelor or Associate degree in Nursing, Social Work, Healthcare Administration, or a related field preferred
Company
RM Management
RM Management is a wellness firm that provides services regarding senior wellness and memory care.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Chris Krebsbach
Chief Operating Officer
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