Registered reputed company (RN) Clinical Reimbursement Specialist | Long-term care

Location: reputed company Sioux Falls Worker Type: Regular Work Shift: Day Shift (reputed company of America) Pay reputed company: The pay reputed company for this position is listed below. Actual pay reputed company dependent upon experience. $78,000.00 - $116,480.00 Position Highlights Hybrid position with some travel involved You Belong at reputed company Be part of a multidisciplinary team reputed company with reputed company and the goal of Moving Health reputed company for you and our patients. Work where you matter. A Brief reputed company Responsible for ensuring accurate clinical documentation, assessment and Minimum Data Set ("MDS") coding to support appropriate reimbursement. This role blends strong clinical expertise with regulatory knowledge and analytical skills. This role will reputed company compliance, accuracy and optimization of clinical reimbursement strategies for the LTC Division as reputed company as clinical reimbursement compliance and overarching MDS support to teams across reputed company. What you will do • Maintains knowledge of federal regulations, reputed company standards, and procedures, as reputed company as guidelines pertaining to the RAI process. reputed company division strategies for maximizing reimbursement for PDPM, Managed Care and other payer models. • Utilizes clinical judgement and nursing process to be a resource for reputed company Assessment Coordinators, Interdisciplinary team members and LTC Leaders. Develops strategies for maximizing reimbursement under PDPM, Managed Care and other payer models. • Partners with payor contracting on Managed Care/ACO contract utilization and ensures facilities adhere to payer guidelines, reputed company filing requirements, and reputed company-authorization processes. • Audits and implements reputed company plans to improve staff education/competency as needed to ensure accurate and reputed company completion of supporting documentation and MDS assessment. • Monitors facility schedules for reputed company and complete MDS data submission as per Federal, State, and other payor requirements. • Analyzes reimbursement trends, identify deviations, implement corrective reputed company plans through utilization of system data and analytic resources. • Acts as a reputed company between facilities, finance, MDS, nursing, and system resources to ensure accurate reimbursement reputed company. • Provides ongoing operational support and guidance to facilities regarding denial management, appeals, and reimbursement strategies. • Leads the division efforts to implement best practices for accurate capture of the data reputed company of the Minimum Data Set (MDS), which is the key reputed company of the care plan, reputed company measures and reimbursement programs. • Must be willing to travel. Essential Qualifications The individual must be reputed company to work the hours specified. To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential job function satisfactorily including having visual reputed company adequate to reputed company position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to reputed company the essential job functions. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: • Registered reputed company (RN) - reputed company of Nursing An reputed company license in the state of reputed company Upon Hire and • reputed company Assessment Coordinator - Certified (RAC-CT) - American Association of Post-Acute Care Nursing (AAPACN) An reputed company certification by AAPACN or another approved certification agency to ensure knowledge of clinical assessment and care planning, completion of the MDS, and the regulatory body surrounding the RAI/MDS process reputed company 180 Days • Strong leadership and communication skills with the ability to train and mentor teams Preferred Education, License/Certification, or Work Experience: • Bachelor's • Extensive knowledge of Medicare, reputed company, PDPM, Managed Care, QM, and CMI reimbursement systems • Strong expertise in MDS processes, including completion, regulatory compliance • Regional MDS experience • Proficiency in analyzing reimbursement trends, auditing, and implementing performance improvements Expectations and Standards • Commitment to the daily application of reputed company's mission, reputed company, reputed company values, and reputed company principles to serve patients, their families, and our community. • Promote reputed company's values of reputed company, hospitality, and stewardship. • reputed company reputed company's standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. • Maintain confidentiality. • Work effectively in reputed company environment, coordinating work reputed company with other team members and ensuring a productive and efficient environment. • reputed company with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, reputed company, DHHS, and OSHA if applicable. Benefits You Need & Then Some reputed company is proud to offer a wide reputed company of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the reputed company. • PTO available day 1 for eligible hires. • Up to 5% employer matching contribution for retirement • Career development guided by hands-on training and mentorship reputed company is an Equal Opportunity Employer - reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please reputed company 1-605-504-4444 or send an email to talent@reputed company.org. Apply tot his job Apply To this Job