Regional Clinical Reimbursement Specialist Metro Boston

(long term care)

(short term rehab)

(skilled nursing)

(sub acute care)

CareOne is hiring for a Regional Clinical Reimbursement Specialist - Metro Boston. This is a Regional Position; expectation is the RCRS will have responsibility for up to FOUR(4) CareOne centers

$140K - $155K

Compensation will be based on, but not limited to, experience, qualifications, credentials and any other relevant information

The Regional Clinical Reimbursement Specialist assures the management of the Medicare, Managed Care and Medicaid reimbursement system for a region-specific number of skilled nursing facilities. Job duties include, but are not limited to:

Implement and direct Medicare and Medicaid auditing and systems review.

Admission pre-screening review

Admission documentation requirement review

Financial documentation requirement review

Clinical documentation assessment

Strategic selection of assessment reference dates

MDS accuracy

ADL score tracking

Denials management

RUGs management

Provide Interdisciplinary Team Training

Consolidated billing

Update facilities on trends, developments, concepts and techniques in the Medicaid and Medicare fields that affect reimbursement services

Engage facility management team in problem solving process to identify improvement opportunities and achieve solution

Facilitate effective, well organized utilization meetings, establish productive objectives and follow through with action plans

Evaluate performance of facility-based staff and make recommendations regarding staff assignments, assessment procedure and reimbursement systems. Ongoing evaluation of the effectiveness of reimbursement staff

Fee Schedule

Position

Requirements

Diploma and/or Degree from credentialed school of nursing. Currently licensed as a Registered Nurse in the state of practice

Minimum of 5 years of experience in long term care

Proven knowledge of quality improvement processes with an emphasis on Medicare, Managed Care and MA Casemix for Skilled Nursing facilities

Multi facility experience with management skills

Excellent oral and written communication skills

Word processing and related computer skills

Current licensing and credentials are required

CareOne Employer Description

The CareOne mission is to define excellence within the health care community. We are dedicated to Maximizing Patient Outcomes. We treat Residents, their families and each other with respect, dignity and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our Centers and Communities. We work to maintain the highest standards of care and service for Residents, families and our valued employees.

We are proud to Offer

Competitive Salary

Comprehensive Healthcare Benefits

401k Retirement Plan

Paid Time Off

Opportunities to advance and grow your career

And More

If working with people who are dedicated, compassionate, and concerned about their patients is essential to you, then you'll appreciate being a part of our team. We've built a strong reputation on the outstanding level of care that we provide. We have a graciously appointed facility with strong belief in patient care and service; join us at our beautiful facility!

We are an Equal Opportunity Employer