Clinical Reimbursement Nurse

RegalCare at Holyoke -

Join the RegalCare of Holyoke Team!
At RegalCare of Holyoke, we are dedicated to providing exceptional care to our residents while supporting our staff with a positive, team-focused work environment. We are currently seeking a Clinical Reimbursement Nurse professional to join our team. Responsibilities:

• Oversee and facilitate the completion of resident assessments in accordance with Federal and State regulations

• Establish assessment schedules and ensure that assessments are done in an accurate and timely manner

• Transmitting assessments to the State of Connecticut, Department of Health

• Coordinate resident care plans in accordance to regulatory requirements, ensuring that resident care is delivered effectively

• Initiate Medicare coverage for newly qualified residents and sending denial letters when necessary

• Remain updated on changes in Medicare coverage and help determine documents necessary for reimbursement.

• Coordinates the assessment, planning, implementation and evaluation of resident care by following the MDS process.

• Coordinates and facilitates care conferences with the interdisciplinary team.

• Coordinates, completes and reviews Minimum Data Sets (MDS)

• Educates, trains and assists nursing staff and other departments regarding the roles of assessments, planning, implementation and MDS process; and completion of applicable sections of MDS.

• Responsible for ensuring all current MDS/PPS updates are implemented and staff is in-serviced.

• Will cross train between PPS and OBRA.

• Conducts regular resident interviews as required by the MDS

Requirements:

Must be a licensed Massachusetts RN or LPN

Minimum 1 year of experience as a Clinical Reimbursement Coordinator (MDS experience required)

Strong communication, organizational, and assessment skills

Why RegalCare of Holyoke?

Supportive, collaborative team environment

Opportunities for professional growth

Comprehensive benefits package