QRM has an exciting opportunity for a Clinical Reimbursement Specialist! We provide rehab management services nationwide and we have an opportunity for the right person to join this growing organization in a Corporate role, covering multiple SNF locations. MUST be a licensed RN with compact licensure, RAC-CT preferred. Ideal candidates will reside in North Carolina. Regular travel may be required.
Summary:
This is a full-time role comprised of Clinical Reimbursement oversight responsibilities for multiple skilled nursing facilities. Please review responsibilities and qualifications carefully before applying.
Responsibilities:
- Provide support to MDS coordinators and interdisciplinary teams including education, process implementation, and ongoing support/management of systems
- Provide ongoing education and guidance to MDS teams to improve coding accuracy, workflow organization, and compliance
- Collaborate with facility staff to identify barriers to success impacting quality measures, Five Star rating, reimbursement capture
- Guide the IDT in implementing best practices relating to the RAI process
- Analyze and report on key performance indicators to measure success and proactively identify areas of need
- Maintain and share expertise/knowledge related to reimbursement and quality outcomes
- Work in conjunction with teams to resolve issues, endorse changes and conduct follow-ups to establish that recommendations are effectively implemented and monitored for appropriateness
- Promote compliance by performing periodic audits of assessments, supporting documentation, and other relevant data
Qualifications:
- Current licensure in the state of employment- Compact licensure preferred
- NC Residency ideal, may consider others who reside in Eastern U.S.
- Prefer RN with multi-site experience
- Experience in high-volume Skilled Nursing Facility with solid understanding (3+ years) of the MDS and RAI Process
- Experience with multiple payment models (PDPM, LTC Case-Mix reimbursement)
- Microsoft Office proficiency required, with the aptitude to learn new programs as needed, being computer savvy is necessary
- Highly motivated and detail oriented professional with excellent analytical and organizational skill set
- Capable of working independently and as part of a team
- Adept skillset for multi-tasking, sense of urgency, ability to prioritize
- Ability to effectively communicate with a wide range of individuals, professional demeanor is imperative
- Ability to travel to client sites as needed
Need professional, outgoing, organized personality ready to learn, motivate, teach and bring valued experience to the table day one! We are a dynamic, growing company and seeking the right team member to occupy this exciting opportunity. Eligibility for benefits (medical/dental/vision/paid holidays/PTO) and competitive pay.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
Work setting:
- Nursing home
- Rehabilitation center
Experience:
License/Certification:
- RN license in NC (Preferred)
Work Location: On the road