RN MDS Coordinator

Job Summary

We are seeking a highly skilled and detail-oriented RN MDS Coordinator to join our healthcare team. The ideal candidate will be responsible for managing the Minimum Data Set (MDS) process, ensuring accurate and timely completion of assessments, and maintaining compliance with Medicare and other regulatory standards. This role requires extensive knowledge of clinical documentation, coding systems, and healthcare regulations, with a focus on optimizing patient care and reimbursement. Experience with EMR/EHR systems such as Epic, Cerner, Athenahealth, or eClinicalWorks is highly preferred. The RN MDS Coordinator will play a vital role in facilitating quality care delivery across inpatient, outpatient, hospice, and long-term care settings.

Duties

• Conduct comprehensive assessments to gather accurate clinical data for MDS and RAI processes.
• Review medical records and documentation to ensure completeness and compliance with HIPAA and NCQA standards.
• Collaborate with interdisciplinary teams including nursing, case management, discharge planning, and medical management to coordinate patient care plans.
• Utilize clinical documentation improvement strategies to enhance accuracy of coding (ICD-10/ICD-9, CPT) and DRG assignments.
• Manage utilization review and utilization management processes to support appropriate patient placement and resource utilization.
• Ensure timely submission of MDS assessments within regulatory deadlines while maintaining high standards of quality.
• Maintain proficiency in EMR/EHR systems such as Cerner, Athenahealth, or eClinicalWorks for documentation review and data entry.
• Stay current with Medicare regulations, NCQA standards, and industry best practices related to managed care, hospital inpatient/outpatient services, ICU/PICU/Trauma Center protocols, and home care settings.
• Provide education and support to staff regarding clinical documentation improvement initiatives.
• Participate in audits and quality assurance activities related to medical records and coding accuracy.

Qualifications

• Valid Registered Nurse (RN) license with current state licensure.
• Extensive experience in acute care settings such as Level I Trauma Centers, Level II Trauma Centers, or critical care units including ICU/PICU/Pediatric units.
• Proven expertise in medical coding (ICD-10/ICD-9), CPT coding, DRG assignment, and utilization review processes.
• Strong knowledge of healthcare systems including Epic EMR/EHR systems, Cerner, Athenahealth, or eClinicalWorks preferred.
• Familiarity with Medicare regulations, NCQA standards, HIPAA compliance, and managed care policies.
• Prior experience in nursing home environments or hospice care is advantageous.
• Excellent analytical skills with the ability to interpret complex medical records and documentation for case management purposes.
• Strong communication skills for collaboration across multidisciplinary teams. This position offers an opportunity to contribute significantly to patient outcomes while ensuring regulatory compliance through expert clinical documentation management.

Job Type: Full-time

Pay: $ $40.68 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $41