Reimbursement Specialist - Healthcare determines the extent to which patients' insurance covers their treatments. Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted. Being a Reimbursement Specialist - Healthcare ensures compliance with Federal and State regulations and company policies that govern Medicare and state payment systems. May assist in identifying fraudulent non-plan billing practices and assists the legal department with litigation preparation. Additionally, Reimbursement Specialist - Healthcare may require a bachelor's degree. Typically reports to a supervisor or manager. Typically requires Certified Professional Coder (CPC) from AAPC or AHIMA. The Reimbursement Specialist - Healthcare gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Reimbursement Specialist - Healthcare typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Good Shepherd Communities is looking for a RN to join our team as our MDS/Reimbursement Coordinator.
Benefits with Full-time employment include: Health, Dental, Vision, Paid Life Insurance, and Long Term Disability, 403(b), Paid Vacation, PTO, and Holidays.
SIGN ON BONUS: $8000.00 total;
After 30 Days= $2000.00
After 90 Days= $2000.00
After 180 Days= $2000.00
After 270 Days= $2000.00
Position Summary
Responsible for MDS coordination. Medicare, determination, and ensuring compliance with all applicable policies and federal/state regulations. Facilitate QAPI. Track nursing department analytics.
MDS/Reimbursement Coordinator Schedule:
Monday- Friday 8am-4:30pm
Expected to assist clinically as needed
Nurse administration on-call rotation (paid at hourly rate)
Essential Job Requirements
Education: Graduate of an accredited School of Nursing
License: Active New York State RN license (Required)
Qualifications:
Experience:
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