What are the responsibilities and job description for the Regional Clinical Reimbursement Specialist position at HFC Management, Inc.?
Position Summary:
Clinical Reimbursement Specialist provides support across assigned HCF facilities in an effort to ensure compliance and accuracy of MDS assessments and PDPM classification. Provide training and support to the Interdisciplinary team as well as any other required assistance to guide the operation of the nursing department.
Position Responsibilities for a Reimbursement Specialist:
* Meet job related competencies as outlined in the Skills Competency Manual
* Provide support to assigned HCF facilities to ensure delivery of quality care and compliance with regulatory guidelines.
* Maintain working knowledge of federal and state regulations for long term care as well as Medicare and Medicaid reimbursement
* Provide initial and ongoing education, monitoring, and support to MDS Coordinators/RNACs and other care community interdisciplinary team members related to:
- Completion and scheduling of MDS assessments
- Completion of care plans
- Medicare and Medicaid reimbursement
- Quality Measure reports
- Regulatory compliance
- Responsibilities, techniques, and practices of restorative nursing care and documentation
* Complete frequent review of medical records and assist in proper completion of nursing forms.
* Monitor nursing care plans, restorative plans, and other nursing programs in each care community assigned
* Monitor all necessary meetings
* Make rounds to monitor nursing care, appearance of residents, and cleanliness of each care community upon all visits
* Be available for consultation and/or on-site visit during federal and state surveys
* Assist in keeping Administrative Manual, QAPI manual, Infection Control and TB Manual, and other manuals current
* Work closely with Administrator, DON, and other members of the care Community Interdisciplinary Team
* Work in conjunction with Corporate Office Interdisciplinary Team
* Efficiently utilize Electronic Health Record system
* Provide back-up and interim support to assigned facilities for MDS/RNAC
* Assume responsibility for maintaining his/her own professional competence
Knowledge, Skills and Abilities: Graduation from an accredited School of Nursing. Current license as an RN in good standing with the Board of Nursing.
Benefits for a Clinical Reimbursement Specialist:
* Promotion opportunities
* Flexibility
* Education/Learning
* Competitive benefit package
What we look for:
Experience: If you've had a job or experience in a position with similar goals and responsibilities, we d love to connect with you.
Skills: We're looking for individuals that are compassionate, team players, social, trustworthy and service-minded.
Characteristics: We're looking for individuals that are self-motivated, dependable, ethical, and ready to jump in and provide outstanding care and customer service to our residents.
The Company
Our Core Values, better known as We Care is that each and every employee in the organization is held to standards of Wholeheartedness, Excellence, Collaboration, Accountability, Respect, and being Ethical. Whether you work for HCF or become a resident of HCF, we can promise you one thing; we will treat you like family!