Clinical Reimbursement Nurse

Join the RegalCare of Holyoke Team!

At RegalCare of Holyoke, we are dedicated to providing exceptional care to our residents while supporting our staff with a positive, team-focused work environment. We are currently seeking a Clinical Reimbursement Nurse professional to join our team. Responsibilities:

• Oversee and facilitate the completion of resident assessments in accordance with Federal and State regulations
• Establish assessment schedules and ensure that assessments are done in an accurate and timely manner
• Transmitting assessments to the State of Connecticut, Department of Health
• Coordinate resident care plans in accordance to regulatory requirements, ensuring that resident care is delivered effectively
• Initiate Medicare coverage for newly qualified residents and sending denial letters when necessary
• Remain updated on changes in Medicare coverage and help determine documents necessary for reimbursement.
• Coordinates the assessment, planning, implementation and evaluation of resident care by following the MDS process.
• Coordinates and facilitates care conferences with the interdisciplinary team.
• Coordinates, completes and reviews Minimum Data Sets (MDS)
• Educates, trains and assists nursing staff and other departments regarding the roles of assessments, planning, implementation and MDS process; and completion of applicable sections of MDS.
• Responsible for ensuring all current MDS/PPS updates are implemented and staff is in-serviced.
• Will cross train between PPS and OBRA.
• Conducts regular resident interviews as required by the MDS
  
  
  

Requirements:

Must be a licensed Massachusetts RN or LPN

Minimum 1 year of experience as a Clinical Reimbursement Coordinator (MDS experience required)

Strong communication, organizational, and assessment skills

Why RegalCare of Holyoke?

Supportive, collaborative team environment

Opportunities for professional growth

Comprehensive benefits package