Regional MDS Clinical Reimbursement Specialist

Regional MDS Clinical Reimbursement Specialist

CCR, a Virginia owned and operated company, based in Roanoke, VA is currently searching for a dynamic Regional MDS Clinical Reimbursement Specialist to join our team.

The Regional MDS Clinical Reimbursement Specialist is responsible for providing oversight, support, education, and quality assurance services to CCR centers relative to RAI & Clinical Reimbursement processes. CCR, Inc. manages twelve health and rehabilitation centers across the Commonwealth of Virginia. Six centers make up the current assignment and are primarily in Central and Southwest areas of the state; however, travel and support to the other 6 centers in the state may be required occasionally. This position is multi-faceted and crosses into several important areas of the organization that require regular visits to assigned centers in addition to remote audits, virtual meetings, and collaboration with the Clinical Services team.

Benefits for our full-time positions include:

• Health, dental, vision, and life insurance
• 10 vacation days, accrued from day 1
• 7 Paid Holidays, Sick time
• 401(k) with employer matching
• Health savings account
• Employee assistance program

We are looking for a Regional MDS Clinical Reimbursement Specialistto:

• Provide guidance, audits, education, and consultation to centers for efficient, timely and accurate and optimal execution of the RAI and Clinical Reimbursement processes per regulatory guidelines, payer guidelines, and individual patient need.
• Effectively communicate findings, needs and recommended actions or improvements to center MDS, Interdisciplinary teams, Administrators, Clinical leadership, other CCR Regional teams, and CCR Senior Management.
• Collaborate with the Clinical Services Team to assist centers to analyze and improve Key Quality Measures and Value Based Payment Performance Indicators.
• Develop MDS Coordinators through on-going training and providing orientation and training to new MDS Coordinators, and any persons responsible for the MDS, Care Plans, and QAPI.
• Perform all duties and responsibilities of a center level MDS Coordinator as needed in times of heavy workload and/or crisis staffing needs.
• Assist in the State and Federal Survey processes and plan of correction development and execution as indicated and requested.

Qualifications:

• Current RN licensure in good standing with the Virginia Department of Health Professions
• Extensive experience with the MDS 3.0/RAI process
• RAC-CT certification will be required, RAC-CTA certification also preferred
• Demonstrated knowledge and understanding of SNF coverage criteria for skilled nursing level care and ancillary services (including therapy services), Medicaid LTC reimbursement, ACO, Bundled Payment, Value Based Payment models and the RAI process
• Ability to adapt quickly to changing regulatory mandates and billing requirements.
• Ability and desire to travel extensively between assigned centers
• Must have a valid VA driver's license
• Ability to demonstrate excellent clinical, customer service, communication, and leadership skills
• Strong computer skills including experience with Microsoft Office Suite programs including Word, Excel, PowerPoint, Outlook, and Teams
• Familiarity with and ability to adapt quickly to navigation of electronic Health Record software. PointClickCare experience preferred
• Must be flexible, detail-oriented and be able to make effective decisions and work as part of a service excellence team

Be part of a team that is driven by our mission:to provide peace of mind to those we care for: our patients, residents, families, and staff. Help us deliver exceptional patient and employee experiences!